title: Hyperhomocysteinemia, C677T MTHFR polymorphism and ischemic stroke in Tunisian patients.
abstract: BACKGROUND
  Hyperhomocysteinaemia has been identified as a strong risk factor for ischemic stroke (IS). A point mutation in methylene tetrahydrofolate reductase (MTHFR C677T) has been associated with increased plasma homocysteine (Hcy) levels.
  
  
  OBJECTIVE
  This preliminary study aimed to investigate whether hyperhomocysteinaemia and/or MTHFR C677T mutation are associated with ischemic stroke.
  
  
  METHODS
  A case-control study including 50 consecutive patients with confirmed IS and 97 controls was performed. Fasting plasma homocysteine levels, MTHFR C677T genotypes were assessed. Other factors such as hypertension, obesity, dyslipidemia, diabetes mellitus, recurrent stroke tobacco and alcohol were investigated.
  
  
  RESULTS
  Mean plasma homocysteine levels were significantly higher in IS patients than in controls (15.83+/-10.60) μmol/L vs 13.78+/-6.29 μmol/L, p=0.04), while no association of MTHFR C677T variant was observed even with homocysteine. The risk to develop ischemic stroke in hyperhomocysteinemic subjects was 2.4 times more than in subjects with normal Hcy levels (OR= 2.4; 95% CI: 1.13-5.06; p<0.05).
  
  
  CONCLUSIONS
  Our findings suggest that high levels of homocysteine but not MTHFR C677T polymorphism represent risk factors for arterial ischemic stroke in Tunisian subjects.
authors.affiliation: Hematology Department, Military Hospital, 1008 Mont-Fleury, Tunis, Tunisia.
authors.forename: Olfa Ben
authors.initials: OB
authors.lastname: Salem-Berrabah
authors.forename: Ridha
authors.initials: R
authors.lastname: Mrissa
authors.forename: Salem
authors.initials: S
authors.lastname: Machghoul
authors.forename: Abdelhamid Ben
authors.initials: AB
authors.lastname: Hamida
authors.forename: Brahim
authors.initials: B
authors.lastname: N'siri
authors.forename: Chakib
authors.initials: C
authors.lastname: Mazigh
authors.forename: Zied
authors.initials: Z
authors.lastname: Aouni
authors.forename: Ines
authors.initials: I
authors.lastname: Louati
authors.forename: Sami
authors.initials: S
authors.lastname: Layouni
authors.forename: Mabrouka
authors.initials: M
authors.lastname: El Oudi
authors.forename: Nejiba
authors.initials: N
authors.lastname: Fekih-Mrissa
authors.forename: Nasreddine
authors.initials: N
authors.lastname: Gritli
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000235:genetics*; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D011110:Polymorphism, Genetic; D020521:Stroke / Q000209:etiology*; D014416:Tunisia
chemical_list: D042965:Methylenetetrahydrofolate Reductase (NADPH2)