MTHFR C667T基因多态性增加超重/肥胖孕妇妊娠期糖尿病的风险

EFFECT OF MTHFR C677T POLYMORPHISM AND OVERWEIGHT/OBESITY ON THE RISK OF GDM

目的分析孕妇亚甲基四氢叶酸还原酶(methylenetetrahydrofolatereductase,MTHFR)C667T基因多态性与妊娠期糖尿病(gestational diabetes mellitus,GDM)的关系,以及它与超重/肥胖对GDM风险的交互作用。方法选择2015年1月—2017年1月在苏州大学附属第二医院进行正规产检并分娩的158例GDM患者为研究对象,并以同期产检的332例年龄、病史匹配的健康孕妇为对照组,检测BMI值及MTHFR C677T基因多态性。结果 (1)GDM组与对照组MTHFR C677T多态性基因分布比较差异有统计学意义(P=0.005)。(2)GDM组TT型基因比例高于对照组(年龄校正后OR=2.01,95%CI:1.28～3.16,P=0.03)。(3)对体重分层后,当BMI≥24kg/m^2时,TT型基因在二组中的分布比较差异有统计学意义(年龄校正后OR=2.34,95%CI:1.38～3.98,P=0.002)。(4)相加交互作用模型中,AP=0.47(95%CI:0.09～0.86),差异有统计学意义。结论 MTHFR C667T等位基因突变尤其是纯合子突变TT型基因携带增加GDM的风险,在超重/肥胖的孕妇中,TT型基因携带与GDM的发生存在显著相关性。MTHFR C667T基因多态性伴超重/肥胖可能增加GDM的风险。

Objective To analyze the relationship between methylenetetrahydrofolatereductase(MTHFR)C667 T polymorphism in pregnant women and gestational diabetes mellitus(GDM),and its interaction with overweight/obesity on GDM risk.Methods A total of one hundred and fifity-eight GDM cases(GDM group)and three hundred and thirty-two cases with normal pregnancy(control group)who underwent regular maternity examination and delivered in the Second Affiliated Hospital of Suzhou University from January 2015 to January 2017 were selected as the study subjects,and 332 healthy pregnant women matched in age and medical history during the same period were selected as the control group.BMI value and MTHFR C677 T gene polymorphism were detected.Results(1)There were significant differences in the distribution of MTHFR C677 T polymorphism gene between GDM group and control group(P=0.005).(2)TT genotype proportion in GDM group was higher than that in control group(OR=2.01,95%CI:1.28-3.16,P=0.03).(3)After weight stratification,when BMI was more than 24 kg/m^2,the distribution of TT gene in the two groups was significantly different(OR=2.34,95%CI:1.38-3.98,P=0.002).(4)In the interaction model,AP=0.47(95%CI:0.09-0.86),with statistical significance.Conclusion MTHFR C667 T allele mutation,especially homozygote mutation TT gene carriers,increases the risk of GDM.TT gene carriers are significantly correlated with the occurrence of GDM in overweight/obese pregnant women.The Association of MTHFR C667 T gene polymorphism with overweight/obesity may increase the risk of GDM.