Hyperhomocystéinémie, Polymorphisme C677T de la MTHFR et Accidents Vasculaires Cérébraux Ischémiques chez des Patients Tunisiens

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Publiée Aug 31, 2010
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Vol. 88 No 9 (2010): Revue sept. 2010

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Olfa Ben Salem-Berrabah
Nejiba Fekih-Mrissa
Mabrouka El Oudi
Sami Layouni
Ines Louati
Zied Aouni
Chakib Mazigh
Brahim N'siri
Abdelhamid Ben Hamida
Salem Machghoul
Ridha Mrissa
Nasreddine Gritli

Résumé

Prérequis : L’hyperhomocystéinémie est considérée comme un facteur de risque indépendant des accidents vasculaires cérébraux (AVC). La mutation C677T du gène de la 5,10–méthyltétrahydrofolate réductase (MTHFR) est associée à une augmentation de l’homocystéine plasmatique totale.
But: Rechercher si l'hyperhomocystéinémie et/ou la mutation C677T de la MTHFR sont associées aux accidents vasculaires cérébraux ischémiques (AVCI).
Méthodes: Nous avons mené une étude cas-témoins composée de 50 patients atteints d’ACVI et 97 témoins. Les mesures des concentrations plasmatiques de l'homocystéine (Hcy) et le génotypage de la mutation MTHFR C677T ont été effectuées.
D’autres facteurs comme l’hypertension, l’obésité, la dyslipidémie, le diabète, les AVCI récidivantes, le tabac et l’alcool ont été analysés.
Résultats: Les concentrations moyennes de l’homocystéine plasmatique (Hcy) étaient significativement plus élevés chez les patients atteints d’AVCI que chez les témoins (15,83±10.60 μmol/L contre 13,78±6,29 μmol/L, p=0,04). Alors qu'aucune association de la mutation C677T de la MTHFR variante n’a été observée; ni avec la maladie ni avec l’Hcy. Le risque de développer un accident ischémique cérébral chez les sujets hyperhomocystéinémiques est 2,4 fois plus que chez les sujets ayant des taux normaux en Hcy (OR=2,4, IC 95%: de 1,13 à 5,06, p<0,05).
Conclusion: Ces données préliminaires montrent que l'Hcy a un effet sur les accidents vasculaires cérébraux ischémiques indépendamment du polymorphisme C677T en Tunisie.

Mots-clés :

Hyperhomocystéinémie, polymorphisme C677T de la MTHFR, accidents vasculaires cérébraux ischémiques, facteur de risque, Tunisie

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