抗心磷脂抗体、维生素D受体基因多态性与不良妊娠结局的相关性分析

Association of anticardiolipin antibodies and vitamin D receptor SNP with adverse pregnancy outcomes

目的探究产妇抗心磷脂抗体(ACA)、维生素D受体(VDR)基因多态性(SNP)与不良妊娠结局的相关性。方法选取2018年2月至2019年3月佛山市高明区人民医院接收的263例产妇作为研究对象。根据妊娠结局分为良好组(n=190)与不良组(n=73),酶联免疫吸附试验检测血清中ACA抗体滴度值,聚合酶链式反应-限制性片段多态性(PCR-RFLP)法检测不同妊娠结局产妇血清中VDR SNP分型,Hardy-Weinberg遗传平衡定律验证基因型频率是否具有代表性;Logistic回归分析影响不良妊娠结局的危险因素。结果妊娠结局不良组孕周低于良好组,差异具有统计学意义(P<0.05)。不良组血清ACA-IgG、ACA-IgM、ACA-IgA水平均高于良好组,差异均具有统计学意义(均P<0.05)。两组研究对象VDR基因ApaI、TaqI位点实际值符合Hardy-Weinberg遗传平衡定律。不良组ApaI位点CC型基因型频率、C等位型频率高于良好组,TaqI位点TT型基因型频率、T等位型频率高于良好组,差异具有统计学意义(P<0.05)。Logistic回归分析显示ACA-IgG、ACA-IgM、ACA-IgA及VDR基因ApaI、TaqI位点是影响不良妊娠结局的危险因素。结论不良妊娠结局产妇血清ACA滴度值升高,VDRApaI位点C型基因、TaqI位点T型基因携带比例升高,是不良妊娠发生的危险因素。

Objective To explorethe relationship between anticardiolipin antibodies(ACA)and vitamin D receptor(VDR)single nucleotide polymorphism(SNP)and adverse pregnancy outcomes.Methods 263 pregnant women diagnosed and treated in People's Hospital of Gaoming District from February 2018 to March 2019 were selected as the study objects,and according to the pregnancy outcome,they were divided into good group(n=190)and poor group(n=73).Enzyme-linked immunosorbent assay(ELISA)was used to detect the titer of ACA anti-body in serum;polymerase chain reaction-restriction fragment polymorphism(PCR-RFLP)was used to detect the serum VDR SNP typing in parturients with different pregnancy outcomes.Hardy-Weinberg's law of genetic balance was used to verify the representativeness of genotype frequencies.Logistic regression analysis was performed to analyze risk factors affecting adverse pregnancy outcomes.Results The gestational weeks of the poor group were lower than those of the good group,with statistically significant differences(P<0.05).Serum levels of ACA-IgG,ACA-IgM and ACA-IgA in poor group were significantly higher than those in good group,with statistically significant differences(P<0.05).The actual values of ApaI and TaqI loci of VDR genes in the two groups conformed to Har-dy-Weinberg's law of genetic balance.The CC genotype frequency and C allele frequency of ApaI locus in poor group were higher than those in good group,while TT genotype frequency and T allele frequency of TaqI locus were significantly higher than those in good group,all with statistically significant differences(P<0.05).Logistic regression analysis showed that ACA-IgG,ACA-IgM,ACA-IgA,VDR gene ApaI,TaqI loci were risk factors for adverse pregnancy outcomes.Conclusions The serum ACA titer of parturients with adverse pregnancy outcomes increase,and the proportion of carrying C-type gene and T-type gene of VDRApaI locus increase,which are all risk factors of adverse pregnancy.