Introduction: Methylenetetrahydrofolate Reductase (MTHFR) is involved in the reduction of 5, 10-methylentetrahydrofolate. A 677C?T single nucleotide polymorphism (SNP) localized in the MTHFR gene was associated with both thermo ability and reduced activity of the enzyme and is associated with increased homocystein levels. Homocystein may impair vascular endothelial cell function. Higher serum homocystein levels among patients with Coronary heart disease (CHD) have been established. Folic acid decreases the level of homocystein and is very useful for coronary artery disease.
Material and methods: This study included 400 subjects (222 cases & 178 controls). For all participants in this study Lipid profile, Homocystein, Folic acid, Blood glucose, Blood pressure, BMI and genetic polymorphism of MTHFR (Allele of C677T) tests were done.
Results: The percentage distribution of the different genotypes in the study population showed that the CC genotype was the most prevalent one followed by CT and then TT (52.7%, 42.79%, 4.51% in patients) (53.3%, 42.8%, 4% in controls). The mean of Hcy level in cases is 14.36 and controls is 11.97. The mean of acid folic in cases is 11.57 and controls are 10.92. the prevalence of hypertension was 23.8% (mostly grade 1), 31% had impaired fasting blood sugar .A cholesterol level of more than 260 mg/dl was found in 7.9% of the participants, 19.5% had a low – density lipoprotein level of more than 160 mg/dl, 30.4% had a high – density lipoprotein level of less than 35 mg/dl, and 17.4% had a triglyceride level of more than 200 mg/dl. Body mass index greater than 25 was found in 21.21% of the participants. In regression analysis, plasma tHCY, Folic acid and C677T polymorphism wasn’t significant associated with premature coronary artery disease. Smoking, BMI, FBS, Chol., TG, LDL and HDL hadn’t significant associated with PCAD.
Discussion: There was no significant association of T Allele in PCAD group when compared to control group. It showed that a lack of association between PCAD and HCY or Folic acid. It’s seemed that the high levels of homocystein and low level of folic acid in PCAD are not dependent on MTHFR activity and many other factors such as diabetes mellitus, hyper lipidemia, BMI, hyper pressure and smoking.