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Exp Clin Endocrinol Diabetes 2003; 111(3): 132-138
DOI: 10.1055/s-2003-39785
Article

J. A. Barth Verlag in Georg Thieme Verlag Stuttgart · New York

The Association Between End-Stage Diabetic Nephropathy and Methylenetetrahydrofolate Reductase Genotype with Macroangiopathy in Type 2 Diabetes Mellitus

G. Hasegawa 1 , H. Obayashi 2 , K. Kamiuchi 1 , M. Nakai 3 , T. Kanatsuna 3 , M. Yamaguchi 4 , T. Tanaka 4 , H. Shigeta 4 , M. Fujii 5 , T. Yoshikawa 1 , N. Nakamura 1
  • 1The First Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • 2The Department of Clinical Research, Kyoto Microbiological Institute, Kyoto, Japan
  • 3The Department of Internal Medicine, Nishijin Hospital, Kyoto, Japan
  • 4The Department of Internal Medicine, Kyoto First Red Cross Hospital, Kyoto, Japan
  • 5The Department of Internal Medicine, Kobe Central Hospital, Kobe, Japan
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Publication History

Received: April 2, 2002 First decision: July 22, 2002

Accepted: December 19, 2002

Publication Date:
04 June 2003 (online)

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Abstract

The T/T genotype of the methylenetetrahydrofolate reductase C677 T gene polymorphism is associated with elevated homocysteine levels and presumably with increased atherosclerotic risk. We evaluated the interaction between this gene polymorphism and end-stage diabetic nephropathy on the observed prevalence of macroangiopathy in type 2 diabetes mellitus. The methylenetetrahydrofolate reductase 677 C/T genotypes were determined in 174 type 2 diabetic patients: 80 with and 94 without renal failure due to diabetic nephropathy. In the patients with renal failure, the T/T genotype and T allele were significantly associated with macroangiopathy (T/T; 31 % vs. 2 %, P = 0.0001 T allele; 59 % vs. 29 %, P = 0.00014), whereas the associations were not significant in the patients without renal failure. In the multiple logistic regression analysis, age (10 years OR 4.05 [1.79 - 9.31], P < 0.0005) and 677 T allele (6.84 [2.12 - 22.05], P = 0.0013) were significantly associated with macroangiopathy in the patients with renal failure. In conclusion, this study demonstrated that the 677 T/T genotype and T allele of MTHFR were significantly associated with macroangiopathy in type 2 diabetic patients with renal failure. The MTHFR 677 T allele, together with renal dysfunction due to diabetic nephropathy, could be a strong risk factor for atherosclerotic disease.

Key words

Atherosclerosis - polymorphism - methylenetetrahydrofolate reductase - renal failure

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M. D. Goji Hasegawa

First Department of Internal Medicine, Kyoto Prefectural University of Medicine

465 kajii-cho, Kawaramachi-Hirokoji, kamikyo-ku,

Kyoto 602-8566

Japan

Phone: + 81752515505

Fax: + 81752523721

Email: goji@koto.kpu-m.ac.jp