血清Hcy、FA及MTHFR水平与妊娠高血压综合征关系

Correlation between the levels of serum serum homocysteine,folic acid,and methylenetetrahydrofolate reductase of pregnant women and their pregnancy-induced hypertension occurrence

目的:探究血清同型半胱氨酸(Hcy)、叶酸(FA)及亚甲基四氢叶酸还原酶(MTHFR)水平与妊娠高血压综合征关系。方法:2020年10月-2022年10月本院收治的104例妊娠高血压综合征患者纳入病例组,按病情严重程度分为轻度妊娠高血压(A组)、中度子痫前期(B组)及重度子痫前期(C组),健康孕妇67例纳入对照组,荧光定量PCR技术测定MTHFR基因型及等位基因,比较各组血清Hcy、FA水平及MTHFR基因C677T多态性。经Spearman相关分析病例组血清Hcy、FA与病情程度关系,采用logistic回归分析评估影响妊娠高血压综合征危险因素。结果:病例组CRP、UA、TC、TG、ApoA1、ApoB、Hcy均高于对照组,FA水平低于对照组,MTHFR基因677位点CT、TT基因型及总的突变T等位基因频率均高于对照组,且病例组各程度组上述各指标有差异(均P<0.05)。经Spearman相关分析,病例组血清Hcy与病情严重程度正相关性,FA与病情严重程度负相关性(P<0.05);相关因素多因素logistic回归分析,基因型CT、基因型TT及T等位基因均属影响妊高征发生的独立危险因素(P<0.05)。结论:妊娠高血压综合征患者血清Hcy水平异常升高、FA水平明显降低,且与病情严重程度相关。早期检测可为病情评估提供依据;基因型CT型、TT型及T等位基因频率是发生妊娠高血压疾病的独立危险因素。

Objective:To explore the correlation between the levels of serum homocysteine(Hcy),folic acid(FA),and methylenetetrahydrofolate reductase(MTHFR)of pregnant women and their pregnancy-induced hypertension(PIH)occurrence.Methods:104pregnant women with PIH were included in study group,and 67healthy pregnant women were included in control group from October 2020to October 2022.The women in the study group were divided in group A(women with mild PIH),group B(women with moderate PIH),and group C(women with severe PIH).The genotypes and alleles of MTHFR of the women were determined by fluorescence quantitative PCR.The serum Hcy and FA levels and the polymorphism of MTHFR gene C677Tof the women were compared among these groups.Spearman correlation analysis was used to analyze the correlation between the serum Hcy and FA levels of the women and their severity of PIH.Logistic regression analysis was used to evaluate the risk factors of PIH of the women.Results:The levels of CRP,UA,TC,TG,ApoA1,ApoB,and Hcy of the women in the study group were significantly higher than those of the women in the control group,but the FA level of the women in the study group was significantly lower than that of the women in the control group.The CT and TT genotype and the total mutated T allele frequency of the MTHFR gene 677of the women in the study group were significantly higher than those of the women in the control group,and all which of the women had significant differences among group A,group B,and group C(all P<0.05).Spearman correlation analysis showed that the serum Hcy level of the women in the study group was positively correlated with their severity of PIH,but the FA level was negatively correlated with their severity of PIH(P<0.05).Multivariate logistic regression analysis showed that genotype CT,genotype TT,and T alleles of the MTHFR gene 677of the women were all the independent risk factors of their PIH occurrence(P<0.05).Conclusion:The level of serum Hcy of the pregnant women with PIH increases abnormally,the level of FA decreases significantly,and both of which are related to the severity of PIH.Early detection of the levels of the serum Hcy and FA of the women can provide evidences for evaluating their severity of PIH.The genotype CT,genotype TT,and T alleles of the MTHFR gene 677of the women are all their independent risk factors of PIH occurrence.