MTHFR基因C677T多态性与妊娠期糖尿病自发性早产及其危险因素分析  

Relation between MTHFR C677T polymorphism and spontaneous preterm birth in gestational diabetes mellitus and its risk factors

作　　者：方建红 卢伟 杨燕 于雪梅 FANG Jianhong;LU Wei;YANG Yan;YU Xuemei(Department of Obstetrics,People’s Hospital of Chengyang District,Qingdao,Shandong 266109,China)

机构地区：[1]青岛市城阳区人民医院产科,山东青岛266109

出　　处：《中国优生与遗传杂志》2021年第2期268-272,共5页Chinese Journal of Birth Health & Heredity

基　　金：青岛市城阳区科学技术局项目(青城科字(2015)25号);国家卫生计生委医药卫生科技发展研究中心项目(W2015CAE169);国家自然科学基金(81402689)。

摘　　要：目的探讨和分析MTHFR基因C677T多态性与妊娠期糖尿病自发性早产及其危险因素。方法回顾性收集2015年1月-2019年12月于青岛市城阳区人民医院就诊的妊娠期糖尿病(gestational diabetes mellitus,GDM)患者160例,其中发生自发性早产的患者80例(早产组),余下80例患者正常足月分娩(足月组),统计两组患者自发性早产的危险因素。分别提取两组患者外周血DNA,通过特异性PCR扩增鉴定亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性,具体基因类型包括野生型CC(CC型)和杂合型CT(CT型)、纯合型TT(TT型)三种。分析早产组和足月分娩组基因型差异,以及不同基因型患者早产发生率和发病危险因素的比较。结果妊娠期糖尿病患者早产组MTHFR基因C677T位点CC野生型占比和等位基因C频率均低于足月组(P<0.05),而TT纯合型占比和等位基因T频率高于足月组(P<0.05)。进一步针对MTHFR基因C677T位点的妊娠期糖尿病早产的风险进行比较,CC野生型的发病优势比为0.400(P=0.025),而TT纯合型的发病优势比高达2.785(P<0.001)。此外,单独比较突变型等位基因C和T频率,其优势比分别为0.606(P=0.048)、1.560(P=0.005)。妊娠期糖尿病患者早产组收缩压、舒张压、空腹血糖、糖化血红蛋白等水平和胎盘前置、胎盘早剥、胎膜早破的发生率均高于足月组(P<0.05)。进一步针对MTHFR基因C677T的多态性进行比较,妊娠期糖尿病自发性早产孕妇CC组的收缩压、舒张压、空腹血糖、糖化血红蛋白等水平和胎盘前置、胎盘早剥、胎膜早破的发生率均较低,而TT组上述危险因素的表达水平和发生率最高,CT组次之(P<0.05)。结论妊娠期糖尿病自发性早产患者存在显著的MTHFR基因C677T位点的基因突变,且TT突变与导致自发性早产的危险因素密切相关。Objective To investigate and analyze the relationship between MTHFR C677 T polymorphism and spontaneous preterm birth in gestational diabetes mellitus(GDM)and its risk factors.Methods Totally 160 cases of gestational diabetes mellitus(GDM)were retrospectively collected in our hospital from January 2015 to December 2019,including 80 cases of spontaneous premature delivery(preterm group),and the remaining 80 cases of normal full-term delivery(term group).DNA was extracted from peripheral blood of the two groups,and MTHFR C677 T gene polymorphism was identified by PCR amplification and specific enzyme digestion.The specific gene types included wild-type CC(CC),heterozygous CT(CT)and homozygous TT(TT).Then analyze the genotype difference between preterm delivery group and term delivery group,and compare the incidence of premature delivery and risk factors of different genotypes.Results The percentages of CC wild type and allele C frequency of MTHFR C677 T locus in preterm delivery group were lower than those in full-term group(P<0.05),while the proportion of TT homozygous type and allele T frequency were higher in preterm delivery group than that in full-term group(P<0.05).Furthermore,the risk of preterm delivery of gestational diabetes mellitus at C677 T locus of MTHFR was compared.The incidence odds ratio of wild type CC was 0.400(P=0.025),while that of TT homozygous was 2.785(P<0.001).In addition,the odds ratios of allele C and T were 0.606(P=0.048)and 1.560(P=0.005),respectively.The levels of systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin and the incidence of placenta previa,placental abruption and premature rupture of membranes in preterm delivery group were higher than those in full-term group(P<0.05).Furthermore,compared with C677 T polymorphism of MTHFR,the levels of systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin and the incidence of placenta previa,placental abruption and premature rupture of membranes in CC group

关 键 词：亚甲基四氢叶酸还原酶基因 C677T多态性 妊娠期糖尿病 自发性早产 危险因素 

分 类 号：R714.256[医药卫生—妇产科学]