title: Hyperhomocysteinemia and MTHFR C677T polymorphism in patients with portal vein thrombosis complicating liver cirrhosis.
abstract: BACKGROUND
  Portal vein thrombosis (PVT) is serious complication of liver cirrhosis (LC), especially in the presence of hepatocellular carcinoma (HCC). The liver plays a key role in homocysteine (Hcy) metabolism: mild hyperhomocysteinemia (HHcy) has been described in LC. HHcy is a risk factor for deep vein thrombosis. Methylen-tetrahydrofolate-reductase (MTHFR) C677T polymorphism is the commonest determinant of mild HHcy and has been involved also in cancer development.
  
  
  OBJECTIVE
  To investigate a possible relation between HHcy, MTHFR status, HCC and PVT in patients affected by LC.
  
  
  METHODS
  100 patients affected by LC, 38 with (PVT group, 24 with HCC) and 62 without PVT (LC group, 14 with HCC) sex-, age-, liver disease stage and etiology-matched were assessed for thrombophilia, smoking status, plasma Hcy, MTHFRC677T polymorphism and homocysteine-related vitamin status.
  
  
  RESULTS
  A higher prevalence of HCC, HHcy and MTHFR TT status was observed in PVT group. No significant difference in vitamin status was observed between groups. Patients with HCC showed significantly higher plasma Hcy and higher prevalence of HHcy than patients without HCC. They had also higher prevalence of MTHFR TT status. In patients with TT status (n=11) and HCC, 10 had HHcy e 9 had PVT.
  
  
  CONCLUSIONS
  Mild HHcy is associated to LC may have a role in PVT development and assessment of plasma Hcy may be suggested in patients with LC (especially if complicated by HCC). Association between HCC and MTHFR TT status is intriguing, due the postulated role for this polymorphism in cancer: it may represent a possible link between HCC and PVT.
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy. Electronic address: paoloven@unimore.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ventura
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Venturelli
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Marcacci
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fiorini
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Marchini
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cuoghi
authors.affiliation: Unit of Internal Medicine 2, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Pietrangelo
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000150:complications / Q000235:genetics; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000235:genetics*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000235:genetics; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications / Q000235:genetics; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011169:Portal Vein / Q000473:pathology; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications* / Q000235:genetics
chemical_list: D006710:Homocysteine; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)
keywords: Hepatocellular carcinoma; Homocysteine; MTHFR status; Portal vein thrombosis; Thrombophilia