血清成纤维细胞生长因子-21、亚甲基四氢叶酸还原酶基因多态性与妊娠期亚临床甲状腺功能减退症的相关性

Correlation between serum fibroblast growth facture-21 and methylenetetrahydrofolate reductase gene polymorphisms and subclinical hypothyroidism in pregnancy

目的 探究血清成纤维细胞生长因子-21(FGF-21)、亚甲基四氢叶酸还原酶(MTHFR)基因多态性与妊娠期亚临床甲状腺功能减退症(SCH)的相关性。方法 选取2022年7月至2023年7月山西省临汾市人民医院收诊的妊娠期SCH患者106例为SCH组,另选取院内同期孕检的健康妊娠期女性106例为健康组。收集两组病历资料,筛查SCH的相关因素,分析血清FGF-21、MTHFR基因多态性对SCH发生的评估效能。结果 SCH组的空腹血糖、血清促甲状腺素(TSH)、FGF-21高于健康组(P<0.05);两组CC、CT、TT基因型分布频率比较,差异有统计学意义(P<0.05)。SCH组T等位基因分布频率高于健康组(P<0.05)。多因素分析结果显示,血清FGF-21(OR=3.330,95%CI:1.138~9.743)、MTHFR基因多态性(OR=4.104,95%CI:1.403~12.008)是SCH发生的影响因素(P<0.05)。血清FGF-21、MTHFR基因多态性单一及联合诊断SCH发生的受试者操作特征曲线下面积分别为0.738、0.670、0.851。结论 血清FGF-21水平升高、MTHFR基因TT基因型的妊娠期女性SCH发生风险更高,两项联合具有一定的诊断价值。

Objective To explore the relationship between serum fibroblast growth factor-21(FGF-21) and methylenetetrahydrofolate reductase(MTHFR) gene polymorphisms and subclinical hypothyroidism(SCH) in pregnancy.Methods A total of 106 pregnant SCH patients admitted to Linfen People's Hospital of Shanxi Province from July 2022 to July 2023 were selected as SCH group,and 106 healthy pregnant women who underwent pregnancy examination in the hospital during the same period were selected as healthy group.The medical records of the two groups were collected,the related factors of SCH were screened,and the efficacy of serum FGF-21 and MTHFR gene polymorphisms in evaluating the occurrence of SCH was analyzed.Results Fasting blood glucose,serum thyrotropin(TSH),and FGF-21 in SCH group were higher than those in healthy group(P<0.05).There was statistical significance in the distribution frequency of CC,CT,and TT genotype between the two groups(P<0.05).The distribution frequency of T allele in SCH group was higher than that in healthy group(P<0.05).Multivariate analysis showed that serum FGF-21(OR=3.330,95%CI:1.138-9.743) and MTHFR gene polymorphism(OR=4.104,95%CI:1.403-12.008) were the influencing factors of SCH(P<0.05).The areas under the receiver operator characteristic curves of subjects with single and combined diagnosis of serum FGF-21 and MTHFR gene polymorphism were 0.738,0.670,and 0.851,respectively.Conclusion Pregnant women with elevated serum FGF-21 level and TT genotype of MTHFR gene have higher risk of SCH,and the combination of these two factors has certain diagnostic value.