目的:本研究旨在探讨精氨酸加压素(AVP)基因多态性和血浆和肽素浓度与妊娠期高血压发生的关系。
方法:我们在中国女性中进行了匹配的巢式病例对照研究。在288例妊娠期高血压(GH)患者中检测到AVP基因和血浆肽素的rs3729965,rs3761249,rs1410713,rs2740204和rs2282018位点的基因型,在16-20孕周,82患有先兆子痫(PE),14例慢性高血压合并先兆子痫(CH-PE)及其健康匹配的对照。
结果:对于和肽素的每个自然对数单位增量,GH和PE/CH-PE的风险增加了5.556(调整后比值比[aOR]:6.556,95%置信区间[CI]:2.734-15.717)和3.312倍(aOR:4.312,95%CI:1.168-15.914)。在主导模式下,rs2282018的CC+CT基因型和rs3761249的GG+GT基因型的GH风险高于TT基因型,aOR为1.757(95%CI:1.077-2.867)和1.814(95%CI:1.111-2.963)。rs3729965位点的等位基因A比等位基因G具有更低的PE/CH-PE风险(aOR:0.441,95%CI:0.199-0.978)。然而,rs1410713和rs2740204基因型的频率在病例和对照组之间没有显着差异。与AVP基因和传统因子(TFs)结合的和肽素模型在预测GH和PE/CH-PE方面比TFs模型具有更高的能力。
结论:我们的研究证实,较高的血浆和肽素和AVP基因变异与GH和PE/CH-PE的发生有关。孕中期早期和肽素和AVP基因的检测提高了TFs对GH和PE/CH-PE的预测能力。
This study aims to explore the relationship between polymorphism of the arginine vasopressin (AVP) gene and plasma copeptin concentration with the occurrence of hypertension in pregnancy.
We conducted a matched nested case-control study in Chinese women. The genotypes of rs3729965, rs3761249, rs1410713, rs2740204, and rs2282018 loci of AVP gene and plasma copeptin at 16-20 gestational weeks were detected in 288 patients with gestational hypertension (GH), 82 with preeclampsia (PE), and 14 with chronic hypertension with superimposed preeclampsia (CH-PE) and their healthy matched controls.
For every natural logarithm unit increment in copeptin, the risks of GH and PE/CH-PE increased by 5.556 (adjusted odds ratio [aOR]: 6.556, 95% confidence interval [CI]: 2.734-15.717) and 3.312 times (aOR: 4.312, 95% CI: 1.168-15.914). Under the dominant model, the genotype CC + CT of rs2282018 and GG + GT of rs3761249 had higher risks of GH than genotype TT, with aORs of 1.757 (95% CI: 1.077-2.867) and 1.814 (95% CI: 1.111-2.963). Allele A of rs3729965 loci had a lower risk of PE/CH-PE than allele G (aOR: 0.441, 95% CI: 0.199-0.978). However, the frequencies of rs1410713 and rs2740204 genotypes were not significantly different between cases and controls. The model of copeptin combined with the AVP gene and traditional factors (TFs) had a higher ability than the TFs model in predicting GH and PE/CH-PE.
Our study confirms that higher plasma copeptin and AVP gene variants are associated with the occurrence of GH and PE/CH-PE. The detection of copeptin and AVP gene in the early second trimester improves the predictive ability of TFs for GH and PE/CH-PE.