亚甲基四氢叶酸还原酶基因C677T多态性与睡眠时间的相互作用对卒中的影响

目的:研究中国汉族人群中亚甲基四氢叶酸还原酶基因C677T多态性与睡眠时间之间的相互作用对卒中发病危险的影响.方法:在病例-对照研究和流行病学调查中,分别对245例脑梗死患者,222例脑出血患者及282例无脑血管病对照人群进行了自我报告的睡眠时间分析以及亚甲基四氢叶酸还原酶基因C677T多态性的分析,通过多元logistic同归分析亚甲基四氢叶酸还原酶基因C677T多态性与睡眠时间之间的相互作用对卒中发病危险的影响.结果:经过调整主要混杂因素,多元logistic回归分析显示:(1)睡眠时间延长(每晚睡眠>8h)与脑梗死发病危险显著相关(OR=3.90;95%CI:2.43～6.26);但与脑出血发病危险无显著相关(OR=1.16,95%CI:0.71～1.92);另一方面,失眠(睡眠时间<6 h)与脑梗死及脑出血发病危险均无显著相关.(2)亚甲基四氢叶酸还原酶基因TT基因型显著增加脑梗死发病危险(OR=2.01;95%CI:1.12～3.61);而亚甲基四氢叶酸还原酶基因C677T多态性与脑出血发病危险无显著相关(OR=1.16,95%CI:0.71～1.92).(3)亚甲基四氢叶酸还原酶基因TT基因型与睡眠时间延长之间的相互作用对脑梗死发病危险的影响具有显著的协同作用(OR=6.22;95%CI:2.44～15.83).结论:亚甲基四氢叶酸还原酶基因TT基因型和睡眠时间延长是增加脑梗死发病危险的独立危险因素.中国汉族人群中亚甲基四氢叶酸还原酶基因TT基因型与睡眠时间延长具有对脑梗死发病危险的显著协同作用.

Interaction between methylenetetrahydrofolate reductase C677T gene polymorphism and sleep duration on risk of stroke pathogenesis

OBJECTIVE: To investigate the interaction between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and sleeping duration on risk of stroke in a Chinese Han ethnic population. METHODS: In the case-control study and epidemiological investigation, the self-reported sleep duration and MTHFR C677T polymorphism of 245 patients with cerebral infarction, 222 patients with cerebral hemorrhage and 282 controls were collected. Multiple logistic regression was performed to analyze the interaction between MTHFR C677T polymorphism and sleeping duration on risk of stroke. RESULTS: After adjustment for major confounding variables, multiple logistic regression analysis showed that: (1) There was significant association between long sleep duration (>8 hours of sleep per night) and cerebral infarction (OR=3.90; 95% CI: 2.43-6.26), but not for cerebral hemorrhage (OR=1.16, 95% CI: 0.71-1.92). On the other hand, insomnia (sleep duration less than 6 hours) was neither associated with cerebral infarction nor hemorrhage. (2) MTHFR TT genotype increased the risk of cerebral infarction significantly (OR=2.01; 95% CI: 1.12-3.61), but not for cerebral hemorrhage (OR=1.16, 95% CI: 0.71-1.92). (3)There was a significant synergistic effect of interaction between MTHFR TT677 genotype and long sleep duration on risk of cerebral infarction (OR=6.22; 95% CI: 2.44-15.83). CONCLUSION: MTHFR TT677 genotype and long sleep duration increase the risk of cerebral infarction independent of confounding factors, respectively. Furthermore, there is a significant synergistic effect between MTHFR TT677 genotype and long sleep duration on risk of cerebral infarction in the Chinese Han ethnic population.