Objective: Studies have suggested that the 5, 10-methylenetetrahydrofolate reductase (MTHFR) C677T mutation (alanine → valine) is a risk factor for atherosclerotic disease. We assessed the association between MTHFR gene polymorphism and carotid atherosclerosis in patients with rheumatoid arthritis (RA).

Methods: Forty postmenopausal RA women (mean age: 58⁑5 years, mean duration of RA 14⁑5 years) treated with low dose methotrexate, other concurrent disease modifying anti-rheumatic drugs, non-steroidal anti-inflammatory drugs, steroid (prednisolone ≤5 mg/day) and folic acid (≥1 mg/day) were studied. The genetic polymorphism was detected by the polymerase chain reaction. We measured intima-media thickness (IMT) and plaques of the common carotid arteries by ultrasonography, and evaluated relations among the known risk factors for atherosclerosis, the genetic polymorphism, RA outcomes (Steinbrocker's radiological stage and functional class defined by the ACR criteria) and markers of inflammation (erythrocyte sedimentation rate and C-reactive protein).

Results: Among the 40 subjects, 12 had MTHFR genotype CC, 24 genotype CT, and 4 genotype TT. The frequencies of the MTHFR C and T allele were 0.6 and 0.4, respectively. Between the subjects with the CC genotype and those with the mutant T allele, there was no difference in age, body mass index, blood pressure (BP), lipid, duration of RA, RA outcome indices, rheumatoid factor, acute phase reactants and IMT. Carotid IMT was positively associated with age, systolic BP and antihypertensive drug use. There was no significant association between carotid IMT and the MTHFR C677T mutation.

Conclusion: It is assumed that there was no significant relationship between the MTHFR C677T polymorphism and carotid atherosclerosis in Korean postmenopausal RA women.

Keywords: Rheumatoid arthritis, Atherosclerosis, Methylenetetrahydrofolate reductase, Polymorphism