Mitchell Laura E, Long Jin, Garbarini Jennifer, Paluru Prasuna, Goldmuntz Elizabeth
Institute of Biosciences and Technology, Texas A&M University System Health Science Center, Houston, Texas, USA.
Birth Defects Res A Clin Mol Teratol. 2010 Jan;88(1):48-53. doi: 10.1002/bdra.20622.
Congenital heart defects (CHDs) are the most common, serious group of birth defects. Although relatively little is known about the causes of these conditions and there are no established prevention strategies, evidence suggests that the risk of CHDs may be related to maternal folate status as well as genetic variants in folate-related genes. Efforts to establish the relationships between these factors and CHD risk have, however, been hampered by a number of factors, including small study sample sizes and phenotypic heterogeneity.
The present study examined the relationship between nine genetic variants in eight folate-related genes and a relatively homogeneous group of left-sided cardiac defects in a cohort of 386 case-parent triads. Log-linear analyses were used to assess both maternal and inherited genetic effects.
Analyses of the study data provided marginal evidence that the maternal MTR A2756G (unadjusted p = 0.01) and the inherited BHMT G742A (unadjusted p = 0.06) genotypes influence the risk of this subset of CHDs. However, neither association achieved significance when the false-discovery rate was controlled at 0.05.
These results, which are based on the largest study sample and most comprehensive assessment of the relationship between left-sided cardiac defects and folate-related genes reported to date, provide little evidence that this subset of CHDs is folate related. However, even larger studies and more comprehensive evaluations of the folate pathway genes are required to fully explore the relationship between folate and left-sided cardiac defects.
先天性心脏病(CHD)是最常见且严重的出生缺陷类型。尽管对这些疾病的病因了解相对较少,且尚无既定的预防策略,但有证据表明,CHD的风险可能与母亲的叶酸状态以及叶酸相关基因的遗传变异有关。然而,确定这些因素与CHD风险之间关系的努力受到了一些因素的阻碍,包括研究样本量小和表型异质性。
本研究在一个由386个病例-父母三联体组成的队列中,检测了8个叶酸相关基因中的9个遗传变异与一组相对同质的左侧心脏缺陷之间的关系。采用对数线性分析来评估母体和遗传效应。
对研究数据的分析提供了边际证据,表明母体的MTR A2756G(未校正p = 0.01)和遗传的BHMT G742A(未校正p = 0.06)基因型会影响这一CHD亚组的风险。然而,当将错误发现率控制在0.05时,这两种关联均未达到显著水平。
这些结果基于迄今为止报道的关于左侧心脏缺陷与叶酸相关基因之间关系的最大研究样本和最全面评估,几乎没有证据表明这一CHD亚组与叶酸有关。然而,需要更大规模的研究和对叶酸途径基因进行更全面的评估,以充分探索叶酸与左侧心脏缺陷之间的关系。