妊娠相关蛋白A、过氧化物酶体增殖物激活受体-γ基因多态性与子痫前期的易感性和妊娠结局的关系研究

Relationship Study between Pregnancy-Associated Protein A and PeroxisomeProliferator-Activated Receptor-γGene Polymorphisms and PreeclampsiaSusceptibility and Pregnancy Outcomes

目的:探讨妊娠相关蛋白A(PAPP-A)、过氧化物酶体增殖物激活受体-γ(PPAR-γ)基因多态性与子痫前期(PE)的易感性和妊娠结局的关系。方法:选取2018年7月至2021年6月石家庄妇幼保健院收治的125例PE患者(PE组)及125例本院同期产检健康孕妇(对照组),统计并对比两组临床结局,根据PE患者妊娠结局的不同分为不良组和良好组。检测所有研究对象外周血脱氧核糖核酸(DNA)样本中PAPP-A、PPAR-γ基因单核苷酸多态性(SNP)位点,并对比PE组与对照组、良好组与不良组SNP位点基因型及等位基因频率,并分析其与PE及PE不良妊娠结局发生的关系。结果:PE组与对照组PPAR-γ基因rs10865710、rs4684847位点及PAPP-A基因rs7020782位点的基因型分布比较有统计学差异,且PE组PPAR-γ基因rs10865710等位基因G、rs4684847等位基因T及PAPP-A基因rs7020782等位基因C频率高于对照组(P<0.05);二分类Logistic回归分析显示,PPAR-γ基因rs10865710位点GG基因型(OR=2.641)及G等位基因(OR=1.641)、PPAR-γ基因rs4684847位点CT基因型(OR=3.084)及T等位基因(OR=2.985)、PAPP-A基因rs7020782位点CC基因型(OR=2.104)及C等位基因(OR=1.875)均是PE发生的危险因素(P<0.05)。PE组总不良妊娠结局发生率为33.60%,显著高于对照组的5.60%(P<0.05)。不良组与良好组PPAR-γ基因rs10865710、rs4684847位点及PAPP-A基因rs7020782位点的基因型分布比较有统计学差异,且不良组PPAR-γ基因rs10865710等位基因G、rs4684847等位基因T、PAPP-A基因rs7020782等位基因C频率高于良好组(P<0.05);二分类Logistic回归分析显示,PPAR-γ基因rs10865710位点GG基因型(OR=2.446)及G等位基因(OR=1.503)、PPAR-γ基因rs4684847位点CT基因型(OR=2.225)及T等位基因(OR=2.013)、PAPP-A基因rs7020782位点CC基因型(OR=2.005)及C等位基因(OR=1.950)均是不良妊娠结局的危险因素(P<0.05)。结论:PPAR-γ基因rs10865710、rs4684847位点及PAPP-A基因rs7020782位点可能与PE易感性及PE不良妊娠结局的发生有关,检测两个基因的SNP位点可能有助于评估PE及其不良妊娠结局的发生风险。

Objective:To investigate the relationship between pregnancy-associated protein A(PAPP-A)and peroxisome prolifer-ator-activated receptor-γ(PPAR-γ)gene polymorphisms and preeclampsia(PE)susceptibility and pregnancy outcomes.Methods:125 PEpatients(PE group)who were admitted to Shijiazhuang Maternal and Child Health Hospital from July 2018 to June 2021 and 125 healthypregnant women(control group)who were were examined during the same period were selected.The clinical outcomes in the two groupswere statistically analyzed and compared.According to the different pregnancy outcomes of PE patients,they were divided into poorgroup and good group.The single nucleotide polymorphism(SNP)sites of PAPP-A and PPAR-γgenes in peripheral blood deoxyribonu-cleic acid(DNA)samples of all subjects were detected,and the SNP genotype and allele frequency in the PE group and control group,good group and poor group were compared,and their relationship with PE and adverse pregnancy outcomes of PE were analyzed.Re-sults:The genotype distribution of PPAR-γgene rs10865710 and rs4684847 locus and PAPP-A gene rs7020782 locus were significantlydifferent between the PE group and control group.The frequencies of PPAR-γgene rs10865710 allele G,rs4684847 allele T andPAPP-A gene rs7020782 allele C in the PE group were higher than those in the control group(P<0.05).Binary Logistic regression analy-sis showed that PPAR-γgene rs10865710 GG genotype(OR=2.641)and G allele(OR=1.641),PPAR-γgene rs4684847 CT genotype(OR=3.084)and T allele(OR=2.985),PAPP-A gene rs7020782 locus CC genotype(OR=2.104)and C allele(OR=1.875)were risk fac-tors for PE occurrence(P<0.05).The incidence of total adverse pregnancy outcomes in the PE group was 33.60%,which was significantlyhigher than 5.60%in the control group(P<0.05).The genotype distribution of rs10865710 and rs4684847 locus of PPAR-γgene andrs7020782 of PAPP-A gene locus in the poor group and good group were statistically different,the frequency of PPAR-γgeners10865710 allele G,rs4684847 allele T and PAPP-A gene rs7020782 allele C in the poor group were higher than those in the goodgroup(P<0.05).Binary Logistic regression analysis showed that PPAR-γgene rs10865710 GG genotype(OR=2.446)and G allele(OR=1.503),PPAR-γgene rs4684847 CT genotype(OR=2.225)and T allele(OR=2.013),PAPP-A gene rs7020782 locus CC genotype(OR=2.005)and C allele(OR=1.950)were risk factors for adverse pregnancy outcomes(P<0.05).Conclusion:The rs10865710 and rs4684847locus of PPAR-γgene and rs7020782 locus of PAPP-A gene may be associated with PE susceptibility and adverse pregnancy outcomes ofPE.Detection of SNP locus of these two genes may be helpful to evaluate the risk of PE and adverse pregnancy outcomes.