Genetic susceptibility to coronary artery disease in Bangladesh: evaluation of MTHFR gene polymorphisms (C677T and A1298C) and hyperhomocysteinemia as independent risk factors of coronary artery disease among young Bangladeshi adults

Abstract

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. This study investigates the role of elevated plasma homocysteine (Hcy) levels as an independent risk factor for CAD and explores the association of MTHFR C677T and A1298C gene polymorphisms with onset of CAD in young Bangladeshi population (≤ 50 years). Blood samples and data from 60 CAD patients and 60 healthy controls were analyzed. Biochemical tests were used to measure plasma Hcy levels and other markers of CAD. PCR-RFLP was used for genotype analysis. Our results showed that 11.7% of CAD patients had elevated Hcy levels compared to 6.7% of controls (p = 0.53), indicating a marginally higher prevalence of hyperhomocysteinemia (Hhcy) among CAD patients, though this difference was not statistically significant. The genotype analysis showed 80 individuals with the CC genotype, 35 with CT genotype, and no TT genotype was observed. Genotype analysis identified significant associations between MTHFR genotypes and several risk factors: Hhcy and male gender (p = 0.0004), family history of cardiovascular disease (p = 0.0175), and hypertension (p = 0.0341). Furthermore, we found no significant associations between Hhcy and conventional cardiovascular risk factors, suggesting that Hhcy may contribute to CAD through mechanisms independent of traditional risk factors. Our study also uncovered critical dietary factors associated with CAD risk. Higher intake of sugar (OR = 15.129, 95% CI: 4.273–53.565, p < 0.001) and chicken (OR = 5.776, 95% CI: 1.287–25.923, p = 0.022) were linked to increased CAD risk, whereas frequent fish consumption (OR = 0.227, 95% CI: 0.063–0.816, p = 0.023) was associated with a reduced risk. These findings emphasize the importance of dietary modifications in the prevention of CAD. In conclusion, while our study highlights the potential role of Hhcy and specific dietary patterns in CAD risk, the lack of statistical significance in Hhcy's association with CAD suggests a complex interplay between factors.