CAJ | 학술논문

目的对不同5,10-亚甲基四氢叶酸还原酶（MTHFR）基因型人群叶酸补服的效果进行评价。方法根据MTHFR C677T基因型将113名健康女性分为CC、CT、TT 3组，每组内再随机分为干预组和对照组，干预组给予口服叶酸片400μg/d，服药2个月，对照组不补服叶酸。分别于基线和干预2个月后检测血浆叶酸、红细胞叶酸、血浆同型半胱氨酸（Hcy）水平。结果基线时，TT基因型血浆叶酸低于CC基因型和CT基因型，而TT基因型血浆Hcy高于CC基因型和CT基因型（P<0.05或P<0.01)。补服叶酸2个月后，干预组血浆叶酸水平和红细胞叶酸水平均不同程度的升高，血浆Hcy水平下降。其中，TT基因型的血浆叶酸上升最明显（相较于CC和CT，均P<0.05)；其血浆Hcy下降也最显著（相较于CT，P<0.05)。Logistic回归分析显示，MTHFR基因型为TT是血浆Hcy偏高的危险因素，其风险是CC型的8.078倍。结论对于3种MTHFR基因型叶酸干预均可升高血浆叶酸和红细胞叶酸，降低血浆Hcy水平。TT基因型发生叶酸代谢障碍、血浆Hcy偏高的风险最高。尚不能证实小剂量补服叶酸可以降低血浆Hcy偏高的风险。
목적대불동5,10-아갑기사경협산환원매（MTHFR）기인형인군협산보복적효과진행평개。방법근거MTHFR C677T기인형장113명건강녀성분위CC、CT、TT 3조，매조내재수궤분위간예조화대조조，간예조급여구복협산편400μg/d，복약2개월，대조조불보복협산。분별우기선화간예2개월후검측혈장협산、홍세포협산、혈장동형반광안산（Hcy）수평。결과기선시，TT기인형혈장협산저우CC기인형화CT기인형，이TT기인형혈장Hcy고우CC기인형화CT기인형（P<0.05혹P<0.01)。보복협산2개월후，간예조혈장협산수평화홍세포협산수평균불동정도적승고，혈장Hcy수평하강。기중，TT기인형적혈장협산상승최명현（상교우CC화CT，균P<0.05)；기혈장Hcy하강야최현저（상교우CT，P<0.05)。Logistic회귀분석현시，MTHFR기인형위TT시혈장Hcy편고적위험인소，기풍험시CC형적8.078배。결론대우3충MTHFR기인형협산간예균가승고혈장협산화홍세포협산，강저혈장Hcy수평。TT기인형발생협산대사장애、혈장Hcy편고적풍험최고。상불능증실소제량보복협산가이강저혈장Hcy편고적풍험。
Objective To evaluate the effects of folic acid supplement on subjects with different 5, 10-methylenetet-rahydrofolate reductase (MTHFR) genotypes. Methods One hundred and eleven healthy women were divided into CC, CT and TT groups according to their MTHFR C677T genotypes. In each group subjects were randomly sub-divided into interven-tion (400 μg/d folic acid supplement) and control (usual diet) groups. The plasma folate, red blood cell (RBC) folate and plasma homocysteine (Hcy) concentration were measured at baseline and two months after intervention. Results The plasma folate was lower and the plasma Hcy was higher in the TT genotype than those in CC or CT genotypes (P<0.05 or P<0.01). After two months of intervention, the levels of plasma folate, RBC folate concentration increased while the plasma Hcy concen-tration decreased in all three intervention groups. Although the plasma folate concentration increased the most obvious in TT genotype than that of CC and CT genotypes, P<0.05), the plasma Hcy concentration decreased the most obvious in TT geno-type than that of CT genotype, P<0.05). Logistic regression analysis showed that the MTHFR TT genotype was a risk factor of high Hcy concentration, which was 8.078 times compared with that of CC genotype (P<0.05). Conclusion Folic acid sup-plement can significantly increase plasma folate and red cell folate concentration, and reduce plasma Hcy concentration in all MTHFR genotypes. TT genotype was the most dangerous in disorder of folic metabolic and high Hcy concentration. However, low-dose folic acid supplement cannot reduce the risk of high Hcy concentration.