Polycystic ovary syndrome, the G1691A factor V Leiden mutation, and plasminogen activator inhibitor activity: Associations with recurrent pregnancy loss
Polycystic ovary syndrome, the G1691A factor V Leiden mutation, and plasminogen activator inhibitor activity: Associations with recurrent pregnancy loss
复制标题
DOI：
10.1016/j.metabol.2003.06.001
复制
发表时间：
2003-12-01
影响因子：
9.8
通讯作者：
Sieve, L
中科院分区：
文献类型：
--
作者：
Glueck, CJ;Wang, P;Sieve, L
我们的具体目标是评估血栓形成倾向、纤维蛋白溶解低下和多囊卵巢综合征（PCOS）与复发性流产（RPL）（妊娠20周内连续流产大于或等于3次）的相关性。前瞻性研究中进行了33名白人妇女提到的诊断和治疗PCOS谁随后发现有RPL和16名白人妇女提到的诊断和治疗RPL，谁没有PCOS。将病例组（PCOS-RPL，无PCOS的RPL）与对照组（116名健康白人女性）的G1691 A凝血因子V Leiden、G20210 A凝血酶原、C677 T亚甲基四氢叶酸还原酶（MTHFR）、纤溶酶原激活物抑制剂4G/5G和血小板糖蛋白PL A1 A2基因突变进行比较。病例组与对照组（44名健康成年白人女性）进行血清学凝血试验，包括同型半胱氨酸、蛋白C、S、游离S、抗凝血酶III、抗心磷脂抗体IgG和IgM、稀释Russel氏蝰蛇毒时间、活化部分凝血活酶时间、因子VIII、因子XI、脂蛋白（Lip）（a）和纤溶酶原激活物抑制剂活性（PAI-Fx）。33名患有PCOS的白人女性随后发现患有RPL，占322名既往妊娠≥ 1次并在4.3年内接受PCOS诊断和治疗的白人女性队列的10%。33名PCOS-RPL女性中有6名（18%）和16名无PCOS的RPL女性中有3名（19%）存在因子V Leiden G1691突变，而116名女性对照中有2名（1.7%）存在因子V Leiden G1691突变，Fisher P（p（f））= 0.0016，p（f）= 0.013。33例PCOS-RPL病例与44例女性对照组的高PAI-Fx（> 21.1 U/mL）也存在差异，分别为38%和8%，p（f）= 0.004。在PCOS和非PCOS女性中，血栓形成性G1691 A因子V Leiden突变与RPL相关;纤维蛋白溶解减退（高PAI-Fx）也与PCOS女性的RPL相关。(c)2003爱思唯尔公司All rights reserved.
Our specific aim was to assess associations of thrombophilia, hypofibrinolysis, and polycystic ovary syndrome (PCOS) with recurrent pregnancy loss (RPL) (greater than or equal to3 consecutive pregnancy losses < 20 weeks gestation). Prospective studies were performed in 33 Caucasian women referred for diagnosis and treatment of PCOS who were subsequently found to have RPL and in 16 Caucasian women referred for diagnosis and treatment of RPL, who did not have PCOS. Cases (PCOS-RPL, RPL without PCOS) were compared with controls (116 healthy Caucasian females) for the G1691A Factor V Leiden, G20210A prothrombin, C677T methylenetetrahydrofolate reductase (MTHFR), plasminogen activator inhibitor 4G/5G, and platelet glycoprotein PL A1A2 gene mutations. Cases were compared with controls (44 healthy adult Caucasian females) for serologic coagulation tests including homocysteine, proteins C, S, free S, antithrombin III, anticardiolipin antibodies IgG and IgM, dilute Russel's viper venom time, activated partial thromboplastin time, Factor VIII, Factor XI, lipoprotein (Lip)(a), and plasminogen activator inhibitor activity (PAI-Fx). The 33 Caucasian women with PCOS subsequently found to have RPL were 10% of a cohort of 322 Caucasian women who had >= 1 previous pregnancy and had been referred for diagnosis and therapy of PCOS over a 4.3-year period. The Factor V Leiden G1691 mutation was present in 6 of 33 women (18%) with PCOS-RPL and in 3 of 16 women with RPL without PCOS (19%) versus 2 of 116 (1.7%) female controls, Fisher's P(p(f)) = .0016, p(f) = .013. The 33 PCOS-RPL cases also differed from the 44 female controls for high PAI-Fx (> 21.1 U/mL), 38% versus 8%, p(f) = .004. The thrombophilic G1691A Factor V Leiden mutation is associated with RPL in women with and without PCOS; hypofibrinolysis (high PAI-Fx) is also associated with RPL in women with PCOS. (c) 2003 Elsevier Inc. All rights reserved.