title: B vitamin treatments modify the risk of myocardial infarction associated with a MTHFD1 polymorphism in patients with stable angina pectoris.
abstract: Methylenetetrahydrofolate dehydrogenase (MTHFD1) catalyzes three sequential reactions that metabolize derivatives of tetrahydrofolate (THF) in folate-dependent one-carbon metabolism. Impaired MTHFD1 flux has been linked to disturbed lipid metabolism and oxidative stress. However, limited information is available on its relation to the development of atherothrombotic cardiovascular disease.
  
  
  
  We explored the association between a MTHFD1 polymorphism (rs1076991 C > T) and acute myocardial infarction (AMI), and potential effect modifications by folic acid/B12 and/or vitamin B6 treatment in suspected stable angina pectoris patients (n = 2381) participating in the randomized Western Norway B Vitamin Intervention Trial (WENBIT). During the median follow-up of 4.9 years 204 participants (8.6%) suffered an AMI. After adjusting for established CVD risk factors, the MTHFD1 polymorphism was significantly associated with AMI (HR: 1.49; 95% CI, 1.23-1.81). A similar association was observed among patients allocated to treatment with vitamin B6 alone (HR: 1.53; 95% CI, 1.01-2.31), and an even stronger relationship was seen in patients treated with both vitamin B6 and folic acid/B12 (HR: 2.35; 95% CI, 1.55-3.57). However, no risk association between the MTHFD1 polymorphism and AMI was seen in patients treated with placebo (HR: 1.29; 95% CI, 0.86-1.93) or folic acid/B12 (1.17; 95% CI, 0.83-1.65).
  
  
  
  A common and functional MTHFD1 polymorphism is associated with increased risk of AMI, although the risk seems to be dependent on specific B vitamin treatment. Further studies are warranted to elucidate the possible mechanisms, also in order to explore potential effect modifications by nutritional factors.
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway. Electronic address: yunpeng.ding@uib.no.
authors.forename: Y P
authors.initials: YP
authors.lastname: Ding
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway.
authors.forename: E K R
authors.initials: EK
authors.lastname: Pedersen
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen 5021, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Johansson
authors.affiliation: Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Gregory
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway; Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen 5021, Norway.
authors.forename: P M
authors.initials: PM
authors.lastname: Ueland
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway.
authors.forename: G F T
authors.initials: GF
authors.lastname: Svingen
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway.
authors.forename: Ø
authors.initials: Ø
authors.lastname: Helgeland
authors.affiliation: Bevital AS, Bergen 5020, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Meyer
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway.
authors.forename: Å
authors.initials: Å
authors.lastname: Fredriksen
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen 5021, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen 5021, Norway; KG Jebsen Center for Diabetes Research, Haukeland University Hospital, Bergen 5021, Norway.
authors.forename: O K
authors.initials: OK
authors.lastname: Nygård
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008754:Methylenetetrahydrofolate Dehydrogenase (NADP) / Q000235:genetics*; D008875:Middle Aged; D015778:Minor Histocompatibility Antigens / Q000235:genetics*; D009203:Myocardial Infarction / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics / Q000517:prevention & control*; D009664:Norway; D010641:Phenotype; D011110:Polymorphism, Genetic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D025101:Vitamin B 6 / Q000627:therapeutic use; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D015778:Minor Histocompatibility Antigens; D014803:Vitamin B Complex; D025101:Vitamin B 6; D005492:Folic Acid; C539735:MTHFD1 protein, human; D008754:Methylenetetrahydrofolate Dehydrogenase (NADP)
keywords: B vitamin; MTHFD1; Myocardial infarction; One carbon metabolism