叶酸代谢相关酶基因与妊娠期糖尿病、妊娠期高血压、羊水过少及早产的关系研究

Relationship between folic acid metabolism-related enzyme gene with gestational diabetes,pregnancy-induced hypertension,oligohydramnios and premature delivery

目的探讨妊娠期糖尿病、妊娠期高血压、早产、羊水过少与叶酸代谢相关酶基因风险性及基因频率的关系。方法选择在该院接受叶酸代谢相关酶基因检测的孕妇19211例,分为羊水过少组1480例,妊娠期糖尿病组4506例,妊娠期高血压组513例,早产(先兆早产但不伴分娩)组648例,正常组12064例。分析所有研究对象叶酸代谢相关酶基因型分布特点,并利用χ^(2)检验分析各基因型频率及叶酸利用风险性与妊娠期糖尿病、妊娠期高血压、早产、羊水过少的关系。结果在该院受检的孕妇5,10-亚甲基四氢叶酸还原酶(MTHFR)基因1298A>C位点AA、AC、CC基因型频率分别为62.75%、32.73%、4.52%,MTHFR基因677C>T位点CC、CT、TT基因型频率分别为44.22%、43.06%、12.72%,甲硫氨酸合成酶还原酶(MTRR)基因66A>G位点AA、AG、GG基因型频率分别为55.30%、37.82%、6.88%。羊水过少组孕妇检出叶酸利用能力高风险的比例增高,且MTHFR 677C>T基因型占比和等位基因频率与正常组比较,差异有统计学意义(P<0.05)。妊娠期高血压组孕妇检出叶酸利用能力中风险、高风险的比例均高于正常组,MTHFR 677C>T基因型占比和等位基因频率与正常组比较,差异有统计学意义(P<0.05)。妊娠期糖尿病组孕妇检出叶酸利用能力无风险的比例增高,MTHFR 677C>T基因型占比和等位基因频率与正常组比较,差异有统计学意义(P<0.05)。早产组孕妇检出叶酸利用能力高风险的比例增高,MTHFR 1298A>C和MTRR 66A>G基因型占比和等位基因频率与正常组比较,差异有统计学意义(P<0.05)。结论机体叶酸利用能力风险性越高,妊娠期发生高血压、早产、羊水过少等合并症的概率越大,并且妊娠期高血压对叶酸利用能力的变化更为敏感。MTHFR 677C>T与羊水过少、妊娠期高血压、妊娠期糖尿病的发生有关;早产的发生同时受MTHFR 1298A>C和MTRR 66A>G的影响。

Objective To investigate the relationship between gestational diabetes,pregnancy-induced hypertension,premature delivery and oligohydramnios with the risk and gene frequency of folic acid metabolism-related enzyme genes.Methods A total of 19211 parturients receiving the folic acid metabolism-related enzyme gene test in this hospital were selected,including 1480 cases in the oligohydramnios group,4506 cases in the gestational diabetes mellitus group,513 cases in the pregnancy-induced hypertension group,648 cases in the premature(threatened premature labor but without delivery)delivery group and 12064 cases in the normal pregnancy group.The distribution characteristics of all genotypes of folic acid metabolism-related enzyme were analyzed,and theχ^(2) test was used to analyze the relationship between the gene types frequency and the risk of folic acid utilization with gestational diabetes mellitus,pregnancy-induced hypertension,premature delivery and oligohydramnios during pregnancy.Results The gene frequencies of AA,AC,and CC genotypes at the 1298A>C site of the methylenetetrahydrofolate reductase(MTHFR)gene in the tested pregnant women in this hospital were 62.75%,32.73%and 4.52%,respectively,the frequencies of MTHFR gene 677C>T site CC,CT and TT genotypes were 44.22%,43.06%and 12.72%respectively,and the frequencies of AA,AG and GG genotypes at the 66A>G site of the methionine synthase reductase(MTRR)gene were 55.30%,37.82%,6.88%respectively.The proportion of pregnant women in the oligohydramnios group at high risk of folic acid utilization was increased,moreover the proportion of MTHFR 677C>T genotype and allele frequency had the statistically significant difference compared with those in the control group(P<0.05);the proportions of middle risk and high risk of folic acid utilization ability detected in pregnant women of the pregnancy-induced hypertension group were higher than those in the normal group,moreover the proportion of MTHFR 677C>T genotype and allele frequency had statistical difference compared with those in the normal group(P<0.05);the proportion of no risk of folic acid utilization ability detected in the pregnant women of the gestational diabetes mellitus group was increased,the proportion of MTHFR 677C>T genotype and allele frequency had statistical difference compared with those in the normal group(P<0.05);the proportion of high risk of folic acid utilization ability detected in pregnant women in the premature delivery group was increased,and the proportions of MTHFR 1298A>C and MTRR 66A>G genotypes and allele frequency had statistical difference compared with those in the normal group(P<0.05).Conclusion The higher the risk of folic acid utilization ability in the body,the greater the probability of complications such as hypertension,premature delivery and oligohydramnios during pregnancy,moreover the pregnancy-induced hypertension is more sensitive to changes in folic acid utilization;the MTHFR 677C>T gene is related with oligohydramnios,pregnancy-induced hypertension and gestational diabetes,and the occurrence of premature delivery is simultaneously affected by MTHFR 1298A>C and MTRR 66A>G.