Association of MTHFR C677T polymorphism with severity and localization of chronic atrophic gastritis: a case control study

Abstract Background Previous reports indicate that the methylenetetrahydrofolate reductase (MTHFR) 677C > T polymorphism plays a role in gastric cancer. However, whether it influences the development and progression of atrophic gastritis remains unclear. We aim to determine the possible association between the MTHFR 677C > T polymorphism and the severity of atrophic gastritis. Methods A total 128 patients with atrophic gastritis were included in the study. The presence and severity of gastric atrophy was assessed by histology using OLGA and OLGIM Gastritis Staging System. MTHFR 677C > T genotyping was performed by digital fluorescence molecular hybridization. Categorical variables were analyzed by percentages using the χ2 test. Results In this study, the TT genotype was significantly more frequent among patients aged ≤ 44 years (age ≤ 44 years vs. >44 years, P = 0.039). Patients with the TT genotype showed a higher ratio of incisura with atrophy or intestinal metaplasia (TT vs. CC + CT, P = 0.02). Furthermore, the TT genotype was associated with more severe lesions compared with the CC + CT genotypes (TT vs. CC + CT for atrophy: odds ratio [OR] = 2.18, P = 0.07; for intestinal metaplasia: OR = 3.39, P = 0.02; for moderate-to-severe lesions: OR = 3.84, P = 0.02). OLGA and OLGIM stages III-IV were observed more frequently in patients with the TT genotype compared with the CC + CT genotypes (for OLGA: OR = 3.98, P = 0.004; for OLGIM: OR = 2.45, P = 0.04). Conclusions The MTHFR 677C > T TT genotype showed an increased risk of moderate-to-severe lesions by OLGA and OLGIM stages, and these results suggest that the MTHFR C677T polymorphism may serve as a predictive marker for precancerous gastric lesions, especially in patients aged ≤ 44 years.