ApoE基因多态性与高水平Hcy的协同作用对妊娠高血压的影响

The synergistic effect of ApoE gene polymorphism and high levels of Hcy on hypertension disorders of pregnancy

摘要

目的 为探究载脂蛋白E(ApoE)基因多态性与同型半胱氨酸(Hcy)的协同作用对妊娠高血压发病的影响。方法 选取2021年1月至2021年12月新疆维吾尔自治区人民医院收治的200例妊娠期高血压孕妇作为研究组,同期非妊娠高血压孕妇200例作为对照组,检测两组孕妇ApoE基因多态性以及Hcy水平。结果 研究组蛋白尿、水肿、胎儿生长受限、羊水过少的发生率均显著高于对照组(χ²值介于10.751~34.783之间,P<0.01),且血中Hcy水平显著高于对照组(t=3.210,P<0.05).研究组ε2ε3、ε3ε3基因型频率以及ε2、ε3等位基因频率均显著低于对照组,ε3ε4、ε4ε4基因型频率以及ε4等位基因频率均显著高于对照组(χ²值介于4.624~32.172之间,P<0.05),ε2ε2、ε2ε4基因型频率略高于对照组但无显著性差异(χ²值分别为1.309、0.069,P>0.05).研究组E3、E4 ApoE表型孕妇的Hcy水平均显著高于对照组(t值分别为4.009、2.609,P<0.05),且研究组E4表型孕妇的Hcy水平显著高于E2、E3(F值为4.118,P<0.05).E4表型中研究组孕妇的高Hcy比例显著高于对照组(χ²=4.650,P<0.05),而E2、E3表型中两组孕妇的高Hcy比例均无显著性差异(χ²值分别为3.678、3.432,P>0.05)。结论 ApoE基因多态性和高水平Hcy在妊娠期高血压疾病发病中存在协同作用,ApoE基因ε4等位基因的存在与高Hcy水平之间的相互作用会增加妊娠期高血压疾病发生的风险.

Abstract

Objective In order to explore the synergistic effect of apolipoprotein E (ApoE) gene polymorphism and homocysteine (Hcy) on hypertension disorders of pregnancy. Methods A total of 200 pregnant women with gestational hypertension admitted to the people's hospital of Xinjiang Uygur Autonomous Region from January 2021 to December 2021 were selected as the study group, and 200 pregnant women with non-gestational hypertension during the same period were selected as the control group, and the ApoE gene polymorphism and Hcy levels of pregnant women in both groups were detected. Results The incidence of proteinuria, edema, fetal growth restriction and oligohydramnios in the study group was significantly higher than that in the control group (χ²=10.751-34.783, P<0.01). The serum Hcy level was significantly higher than that of control group (t=3.210, P<0.05). The genotype frequencies of ε2ε3 and ε3ε3 genotype and the frequency of ε2 and ε3 allele in study group were significantly lower than those in control group, while the frequencies of ε3ε4 and ε4ε4 genotype and ε4 allele were significantly higher than those in control group (χ²=4.624-32.172, P<0.05). The genotype frequencies of ε2ε2 and ε2ε4 were slightly higher than those of the control group, but there was no significant difference (χ²=1.309 and 0.069, respectively, P>0.05). The Hcy levels of pregnant women with E3 and E4 ApoE phenotype in the study group were significantly higher than those of the control group (t=4.009 and 2.609, respectively, P<0.05), and the Hcy levels of pregnant women with E4 phenotype in the study group were significantly higher than those of E2 and E3 (F=4.118, P<0.05). The proportion of HHcy in pregnant women in the study group was significantly higher than that in the control group in the E4 phenotype (χ²=4.650, P<0.05), but there was no significant difference in the HHcy level of the E2 and E3 phenotypes between the two groups (χ²=3.678 and 3.432, respectively, P>0.05). Conclusion There is a synergistic effect of ApoE gene polymorphism and high levels of Hcy in the pathogenesis of hypertensive disorders of pregnancy, and the interaction between ApoE gene ε4 allele and high Hcy level will increase the risk of hypertensive disorders of pregnancy.

关键词

载脂蛋白E / 同型半胱氨酸 / 妊娠期高血压疾病 / 发病风险 / 协同作用

Key words

apolipoprotein E / homocysteine / hypertension disorders of pregnancy / morbidity risk / synergistic effect

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基金资助

新疆维吾尔自治区优秀青年科技人才培养项目(天山青年)(2020Q044)

新疆维吾尔自治区人民医院院级项目(20210113)