Impact of maternal methylenetetrahydrofolate reductase C677T polymorphism on intervillous and decidual pathology with pregnancy loss.
Impact of maternal methylenetetrahydrofolate reductase C677T polymorphism on intervillous and decidual pathology with pregnancy loss.
复制标题
母体亚甲基四氢叶酸还原酶 C677T 多态性对妊娠丢失的绒毛间和蜕膜病理的影响。
DOI：
10.1111/jog.13798
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
et al.,
中科院分区：
文献类型：
--
作者：
Mehandjiev TR;Tenno NM;Yanagihara I;et al.,
目的探讨亚甲基四氢叶酸还原酶（MTHFR） C677T多态性与流产患者绒毛间及蜕膜病理的关系。方法对243例流产患者的绒毛间纤维蛋白和血栓形成程度（IT）、蜕膜纤维蛋白和血栓形成程度（DT）进行横断面研究，并测定其mthfrc677t基因型。还确定了获得病理样本时的年龄、体重指数（BMI）、妊娠、胎次、流产次数和妊娠期的总体差异。结果两组患者在年龄、BMI、妊娠、胎次、流产次数、妊娠期、相对toMTHFRC677T基因型（TT、CT、CC）方面无显著差异。T等位基因携带者和TT基因型患者在严重IT患者（比值比[OR] 1.653，P= 0.033和OR 2.246，P= 0.032）和严重IT合并个体血栓患者（比值比[OR] 2.602，P= 0.012和OR 3.375，P= 0.035）中显著增加。CC基因型对所研究的四种病理分级具有保护作用。结论据我们所知，本研究首次发现thfrc677t TT基因型和T等位基因与妊娠流产患者严重的绒毛间和蜕膜病变相关。mthfrc677ttt基因型病理分级的差异可以支持这样的假设，即根据单核苷酸多态性可以定制进一步的妊娠期治疗。
AimThe association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and intervillous and decidual pathology in patients with pregnancy loss was investigated.MethodsWe performed a cross‐sectional study on 243 patients presenting with pregnancy loss for the degree of intervillous fibrin and thrombosis (IT), and decidual fibrin and thrombosis (DT) and determined theirMTHFRC677T genotypes. Overall differences in age, body mass index (BMI), gravidity, parity, number of pregnancy losses and gestational period when the pathologic samples were obtained, also were determined.ResultsThere were no significant differences in age, BMI, gravidity, parity, number of pregnancy losses and gestational period, relative toMTHFRC677T genotype (TT vs CT vs CC). There were significantly more T allele carriers and TT genotype patients among patients with severe IT (odds ratio [OR] 1.653,P= 0.033 and OR 2.246,P= 0.032, respectively) and those with severe IT and decidual thrombosis (OR 2.602,P= 0.012 and OR 3.375,P= 0.035, respectively). The CC genotype was protective against the four studied pathologic grades.ConclusionTo our knowledge, this is the first study showing that theMTHFRC677T TT genotype and T allele are associated with severe intervillous and decidual pathologies in patients with pregnancy loss. Differences in pathologic grades ofMTHFRC677T TT genotype could support the hypothesis that further periconceptional treatment for pregnancy loss could be customized depending on single nucleotide polymorphisms.