The Influence of MTHFR C677T Variants on Neuropathy Risk Among T2dm Patients Receiving Monotherapy Metformin

Neuropathy is the most prevalent microvascular complication in type 2 diabetes mellitus (T2DM). Metformin consumption is associated with higher neuropathy risk. The Methylenetetrahydrofolate reductase (MTHFR) enzyme has confirmed its role in neuropathy. Metformin and MTHFR may decrease folate and induce hyper-homocysteine. The MTHFR gene variant, C677T, commonly found in exons, was studied for its connection to neuropathy risk in newly diagnosed T2DM patients initiating metformin treatment. This cross-sectional study recruited 103 patients. The neuropathy risk was examined according to medical judgement through Neuropathy Symptom Score (NSS) and Neuropathy Disability Score (NDS) criteria. Genotyping C677T was performed using PCR-RFLP. This study revealed that only one patient had a homozygote mutant, with over 50% of patients were detected with allele mutants. There were no statistical differences in patient characteristics between CC and CT genotypes (p>0.05). The association between C677T and neuropathy risk was not significant statistically, either in the genotype model (p=0.97), allele model (p=0.82), and dominant model (p=0.91). Even after adjusting for several confounding factors, no significant association was observed. In conclusion, C677T in our population did not influence neuropathy risk. More specific criteria and laboratory parameters indicated neuropathy should be examined in future studies.