Relationship Between MTHFR C677T Gene Polymorphism And HCY,ACA And Recurrent Spontaneous Abortion

Objective:1.To analyze the relationship between MTHFR gene polymorphism,HCY,ACA and recurrent spontaneous abortion at different stages;2.Elevated homocysteine was associated with recurrent spontaneous abortion,and elevated plasma HCY increased the risk of RSA.There was no significant difference in plasma HCY levels in different stages of abortion;3.To provide the basis for clinical etiology,diagnosis and treatment of recurrent spontaneous abortion.Methods:From January 2013 to February 2017 in Shanxi Hospital of Obstetrics and gynecology clinic because of recurrent abortion for genetic counseling in 60 cases as the study group.30 cases of abortion,gestational age less than 12 weeks;30cases of abortion 12~28 weeks of gestation.Were selected and at least 1 successful pregnancy,spontaneous abortion,embryo,fetal growth restriction,fetal death and no history of thrombotic disease history of pregnant women as a control group of 60 cases(30 cases;30 cases of less than 12 weeks 12~28 weeks).On two groups of venous blood MTHFR,plasma homocysteine and anticardiolipin antibodies,the application of statistical analysis of MTHFRC667 T,HCY,ACA and the relationship between recurrent spontaneous abortion.Results:1.Study on the age of patients ranged from 25 to 39,of which less than 12 weeks of pregnancy group average age was 30.04�3.26 years old,pregnancy 12~ 28 weeks at an average age of 29.87�1.38 years.The number of pregnancy was2 ~ 6 times,of which less than 12 weeks of pregnancy pregnancy group average of 2.30�1.23 times,from 12 to 28 weeks of pregnancy pregnancy group average of 2.011�.59 times.A BMI of 17.13 ~ 29.25Kg/m2,those with a BMI of less than 12 weeks of pregnancy group average was 20.39�1.13Kg/m2,12~28 weeks of pregnancy BMI group average was 20.91�1.47Kg/m2.Less than 12 weeks of pregnancy and pregnancy in 12 to 28 weeks of age,there was no significant difference on the number of pregnancy and body weight index(P > 0.05).The control group of patients aged 21 to 42 years old,of which less than 12 weeks of pregnancy group average age was 29.31�4.02 years old,pregnancy 12 ~ 28 weeks at an a verage age of 29.55�3.27 years.The number of pregnancy was 1 ~ 4 times,of which less than 12 weeks of pregnancy pregnancy group average of 2.21�1.05 times,from 12 to 28 weeks of pregnancy pregnancy group average of 2.23�1.62 times.A BMI of 16.94 ~ 28.54Kg/m2,those with a BMI of less than 12 weeks of pregnancy group average was 21.08�0.63Kg/m2,12 ~ 28 weeks of pregnancy BMI group average was 20.4�51.52Kg/m2.Less than 12 weeks of pregnancy and pregnancy in 12 to 28 weeks of age,there was no significant difference on the number of pregnancy and body weight index(P>0.05).There was no significant difference between the study group and the control group in age,gestational age,and body mass index(P>0.05).2.There were significant differences in the distribution frequencies of MTH FRC677 T genotype CC,type CT and type TT in the control group and the study group,and the difference was statistically significant(X2=17.62,P<0.01).The fre quency of TT type 40%(24/60)in the study group was significantly higher than that in the control group 6.67%(4/60).The frequency of CC type 18.33%(11/60)in the study group was significantly lower than that in the control group58.33%(35/60).The T allele frequency of 60.73%(73/120)in the study group was signifi cantly higher than that of C allele frequency of 24.17%(29/120),and the difference was significant(X2=18.32,P < 0.01).In the study group were less than 12 weeks and 12 ~ 28 weeks MTHFRC677 T three gene mutation type CC type,CT type,TT type distribution of different frequency,the difference was statistically significant(X2=15.32,P < 0.01).Less than 12 weeks group The control group in less than 12 weeks of pregnancy and pregnancy 12 ~ 28 weeks MTHFRC677 T three gene mutation type CC type,CT type,TT type distribution frequency difference was not statistically significant(X2=6.67,P=0.031).TT frequency of 66.67%(20/30)was higher than that of 12 ~ 28 weeks in group 13.33%(4/30).3.The plasma HCY(13.77�2.01umol/L)in the study group was significantly higher than that in the control group(10.01�0.98umol/L).Single factor analysis of variance,Two groups of plasma homocysteine values between MTHFR C667 T genotypes compared with significant difference(P < 0.001),the genotype of serum HCY value from high to low in the order of TT mutant(15.23�0.87umol/L),heterozygous CT(12.03�1.14umol/L),homozygous CC(8.83�1.48umol/L).Study on the plasma level of HCY group in 12 weeks [(13.26 + 6.44)mol/L] and 12 ~ 28 weeks [(15.0�82.75)mol/L]there was no significant difference between(F=1.18,P=0.331).The level of the control group in plasma HCY weeks of pregnancy less than 12 weeks [(8.87�4.59)mol/L] and 12 ~ 28 weeks of pregnancy [(8.35�3.29)mol/L] there was no significant difference between(F=1.271,P=0.274).4.The positive rate of plasma ACA in the two groups was significantly different(X2=21.39,P < 0.01).The positive rate of ACA in the study group was 11.67%(7/60),higher than that in the control group(6.67%)(4/60).The positive rate of plasma ACA was not significantly different between the two groups of MTHFR and C677T(X2=6.28,P=0.37).The study group and the control group in gestati on weeks less than 12 weeks of pregnancy and 12 ~ 28 weeks,there were no significant differences in the positive rate of ACA(P > 0.05).5.The serum HCY levels in the study group,the positive rate of ACA was significantly higher than that of the control group(P < 0.01 or 0.05),the study group ACA positive serum level of HCY for [(15.92�4.33)mol/L],than patients with ACA negative serum HCY level(11.76�3.86)gmol/L)] was significantly higher(P < 0.01).Conclusion:1.Mutations in the MTHFR C677 T gene are associated with the risk of RSA,and women with the TT genotype increase the risk of RSA,particularly in early pregnancy.For genotype CT,late miscarriage should be prevented.2.The rise of homocysteine was associated with the occurrence of early and late abortion.The increase of plasma HCY may increased the risk of RSA.3.The mutation of MTHFR C677 T gene is one of the factors that cause the increase of serum HCY level.4.ACA and HCY may play a synergistic role in the occurrence of abortion.