Palep-Singh M, Picton H M, Yates Z R, Barth J H, Balen A H
Department of Gynaecology, Saint Mary's University Teaching Hospital, CMMC NHS Trust, Hathersage Road, Manchester, UK.
Eur J Obstet Gynecol Reprod Biol. 2008 Jun;138(2):180-6. doi: 10.1016/j.ejogrb.2007.12.015. Epub 2008 Feb 20.
Elevated plasma homocysteine (Hcy) is a recognized risk factor for cardiovascular disease (CVD) and other defects. Biochemical and genetic studies have characterized molecular determinants contributing to alter Hcy metabolism. The vitamin B12 dependent enzyme methionine synthase (MTR) regulates de novo production of methionine from homocysteine. Defects in the activity of this enzyme may possibly predispose to higher plasma Hcy concentrations.
We examined the associations between plasma Hcy concentrations and a single nucleotide polymorphism (SNP) in the MTR gene (MTR 2756A>G), and plasma folate concentrations, in 71 women (Caucasian and South Asian) attending a fertility clinic. We also determined the ethnic variations in the frequencies of the 3 genotypes of the MTR 2756 A>G gene.
The frequency of the variant G allele was similar in the Caucasians and the South Asians (OR: 1.83; 95% CI: 0.79-4.23, p=0.2). The frequency was also similar in the PCOS and non-PCOS groups (OR: 0.88; 95% CI: 0.39-1.99). Plasma Hcy levels were significantly higher in women with PCOS compared with non-PCOS controls (p=0.05) and in Caucasian women with PCOS compared with Caucasian controls (p=0.04) in the presence of the MTR 2756 AA genotype (wild type). After adjusting for age, BMI, waist circumference and ethnicity, the significant predictors of plasma Hcy concentrations were plasma LDL, whole blood folate concentrations and a clinical diagnosis of PCOS.
The important predictors of plasma Hcy concentration in women of reproductive age are whole blood folate concentrations, a background of PCOS and plasma LDL concentrations. The SNP 2756 A>G in the MTR gene does not appear to influence the plasma Hcy levels.
血浆同型半胱氨酸(Hcy)水平升高是心血管疾病(CVD)及其他缺陷的公认风险因素。生化和遗传学研究已明确了影响Hcy代谢改变的分子决定因素。维生素B12依赖酶甲硫氨酸合成酶(MTR)调节由同型半胱氨酸从头合成甲硫氨酸的过程。该酶活性缺陷可能会使血浆Hcy浓度升高。
我们在71名前往生育诊所就诊的女性(白种人和南亚人)中,研究了血浆Hcy浓度与MTR基因单核苷酸多态性(SNP)(MTR 2756A>G)以及血浆叶酸浓度之间的关联。我们还确定了MTR 2756 A>G基因三种基因型频率的种族差异。
白种人和南亚人中变异G等位基因的频率相似(比值比:1.83;95%置信区间:0.79 - 4.23,p = 0.2)。多囊卵巢综合征(PCOS)组和非PCOS组的频率也相似(比值比:0.88;95%置信区间:0.39 - 1.99)。在存在MTR 2756 AA基因型(野生型)的情况下,PCOS女性的血浆Hcy水平显著高于非PCOS对照组(p = 0.05),且PCOS白种女性的血浆Hcy水平显著高于白种对照组(p = 0.04)。在调整年龄、体重指数、腰围和种族后,血浆Hcy浓度的重要预测因素是血浆低密度脂蛋白(LDL)、全血叶酸浓度和PCOS临床诊断。
育龄女性血浆Hcy浓度的重要预测因素是全血叶酸浓度、PCOS背景和血浆LDL浓度。MTR基因中的SNP 2756 A>G似乎不影响血浆Hcy水平。