Zusterzeel P L, Visser W, Peters W H, Merkus H W, Nelen W L, Steegers E A
Department of Obstetrics and Gynecology, University Hospital Nijmegen St Radboud, The Netherlands.
Obstet Gynecol. 2000 Jul;96(1):50-4. doi: 10.1016/s0029-7844(00)00845-0.
To determine whether genetic variability in biotransformation enzymes contributes to individual differences in susceptibility to preeclampsia or the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP).
Polymorphisms in the genes of glutathione S-transferases and cytochrome P-450 1A1 were assessed by polymerase chain reaction in 170 nonpregnant women with a history of preeclampsia, 90 of whom had HELLP syndrome, and 109 healthy control women with an uncomplicated obstetric history. chi(2) analysis was used for statistical evaluation of differences in polymorphism rates.
A higher frequency of the glutathione S-transferase P1b-1b genotype was observed in preeclamptic women than in controls (14% in preeclampsia and 5% in controls; odds ratio 3.4, 95% confidence interval 1.2, 10. 6, P =.02). Genetic polymorphisms in other glutathione S-transferases and cytochrome P-450 1A1 genes occurred equally frequently in cases and controls. In women with a history of preeclampsia, there were no differences in the occurrence of the genetic polymorphisms investigated in women who either did or did not develop the HELLP syndrome.
Women with the glutathione S-transferase P1b-1b genotype, which could result in lower glutathione S-transferase detoxification capacity, might have higher susceptibility to preeclampsia. However, polymorphisms in glutathione S-transferase genes do not seem to be a risk factor for development of the HELLP syndrome.
确定生物转化酶的基因变异是否会导致个体对先兆子痫或溶血、肝酶升高及血小板减少综合征（HELLP）易感性的差异。
采用聚合酶链反应评估170名有先兆子痫病史的未孕女性、其中90名患有HELLP综合征者以及109名有正常产科病史的健康对照女性谷胱甘肽S-转移酶和细胞色素P-450 1A1基因的多态性。采用卡方分析对多态性率的差异进行统计学评估。
先兆子痫女性中谷胱甘肽S-转移酶P1b-1b基因型的频率高于对照组（先兆子痫组为14%，对照组为5%；优势比3.4，95%置信区间1.2, 10.6，P = 0.02）。其他谷胱甘肽S-转移酶和细胞色素P-450 1A1基因的遗传多态性在病例组和对照组中出现的频率相同。在有先兆子痫病史的女性中，发生或未发生HELLP综合征的女性所研究的基因多态性发生率无差异。
具有谷胱甘肽S-转移酶P1b-1b基因型的女性可能导致谷胱甘肽S-转移酶解毒能力降低，对先兆子痫的易感性可能更高。然而，谷胱甘肽S-转移酶基因多态性似乎不是发生HELLP综合征的危险因素。
