Correlations of MTHFR 677C>T Polymorphism with Cardiovascular Disease in Patients with End-Stage Renal Disease: A Meta-Analysis

Objective: This meta-analysis was conducted to evaluate the correlations of a common polymorphism (677C>T) in the methylenetetrahydrofolate reductase (MTHFR) gene with risk of cardiovascular disease (CVD) in patients with end-stage renal disease (ESRD). Method: The following electronic databases were searched without language restrictions: Web of Science (1945 similar to 2013), the Cochrane Library Database (Issue 12, 2013), MEDLINE (1966 similar to 2013), EMBASE (1980 similar to 2013), CINAHL (1982 similar to 2013) and the Chinese Biomedical Database (CBM) (1982 similar to 2013). Meta-analysis was performed using STATA statistical software. Odds ratios (ORs) with their 95% confidence intervals (95% CIs) were calculated. Results: Eight cohort studies met all inclusion criteria and were included in this meta-analysis. A total of 2,292 ESRD patients with CVD were involved in this meta-analysis. Our meta-analysis results revealed that the MTHFR 677C>T polymorphism might increase the risk of CVD in ESRD patients (TT vs. CC: OR = 2.75, 95% CI = 1.35 similar to 5.59, P = 0.005; CT+TT vs. CC: OR = 1.39, 95% CI = 1.09 similar to 1.78, P = 0.008; TT vs. CC+CT: OR = 2.52, 95% CI = 1.25 similar to 5.09, P = 0.010; respectively). Further subgroup analysis by ethnicity suggested that the MTHFR 677C > T polymorphism was associated with an elevated risk for CVD in ESRD patients among Asians (TT vs. CC: OR = 3.38, 95% CI = 1.11 similar to 10.28, P = 0.032; CT+TT vs. CC: OR = 1.44, 95% CI = 1.05 similar to 1.97, P = 0.022; TT vs. CC+CT: OR = 3.15, 95% CI = 1.02 similar to 9.72, P = 0.046; respectively), but not among Africans or Caucasians (all P > 0.05). Conclusion: Our findings indicate that the MTHFR 677C>T polymorphism may be associated with an elevated risk for CVD in ESRD patients, especially among Asians.