胎盘 C20:4n-6/C20:5n-3 比值和血栓素 B2/6-酮-前列腺素 F1α比值高是神经管缺陷的潜在危险因素：中国山西省的病例对照研究。
High Ratios of C20:4n-6/C20:5n-3 and Thromboxane B /6-Keto-Prostaglandin F in Placenta Are Potential Risk Contributors for Neural Tube Defects: A Case-Control Study in Shanxi Province, China.
机构信息
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.
The Key Laboratory of Cell Proliferation and Regulation Biology of Ministry of Education, Institute of Cell Biology, College of Life Sciences, Beijing Normal University, Beijing, China.
出版信息
Birth Defects Res. 2017 May 1;109(8):550-563. doi: 10.1002/bdr2.1003. Epub 2017 Mar 24.
BACKGROUND
Neural tube defects (NTDs) are severe congenital malformations. Folate supplementation can reduce the risk, but cannot prevent all NTDs, suggesting other reasons for folate-resistant NTDs. The present study assesses placental fatty acid composition, eicosanoids, and cytokines as risk factors for NTDs in a Chinese population with highly incident NTDs.
METHODS
Seventy-seven aborted fetuses with NTDs during the third trimester were cases and 142 healthy newborns were controls. Placental fatty acid composition, eicosanoids, and cytokines were determined by standard methods.
RESULTS
The placental C20:4n-6/C20:5n-3 and thromboxane B (TXB )/6-keto-prostaglandin F (6-keto-PGF ) ratios were significantly higher for cases than controls (p < 0.001 and 0.05, respectively). For the top versus the lowest tertiles of placental C20:4n-6/C20:5n-3 and TXB /6-keto-PGF , odds ratios for NTD occurrence were 3.79 (95% confidence interval, 1.60-8.96) (p for trend < 0.01) and 5.52 (95% confidence interval, 2.07-14.74) (p for trend < 0.001), respectively, adjusted for fetal sex as well as maternal age, occupation, parity, smoking, passive smoking, periconceptional folate supplementation, conception season, and tea drinking. The C20:4n-6/C20:5n-3 and TXB /6-keto-PGF ratios were positively correlated (r = 0.14; p < 0.05). The proportions of C18:2n-6, C18:3n-6, C20:3n-6, C18:3n-3, C20:3n-3, C20:5n-3, and C22:5n-3 were significantly lower in cases than controls, and all negatively associated with NTD occurrence (tertile-specific odds ratios); after adjustment for the potential confounders, these associations remained significant (p for trend < 0.05) except for C20:3n-3.
CONCLUSION
High placental ratios of C20:4n-6/C20:5n-3 and TXB /6-keto-PGF are risk factors for neural tube defects.Birth Defects Research 109:550-563, 2017.© 2017 Wiley Periodicals, Inc.
背景
神经管缺陷（NTDs）是严重的先天性畸形。叶酸补充可以降低风险，但不能预防所有的 NTDs，这表明存在叶酸抵抗性 NTDs 的其他原因。本研究评估了脂肪酸组成、类二十烷酸和细胞因子作为中国高发 NTDs 人群中 NTDs 的风险因素。
方法
在孕晚期，77 例 NTD 胎儿为病例，142 例健康新生儿为对照。采用标准方法测定胎盘脂肪酸组成、类二十烷酸和细胞因子。
结果
病例组胎盘 C20:4n-6/C20:5n-3 和血栓烷 B（TXB）/6-酮前列腺素 F（6-keto-PGF）比值明显高于对照组（p<0.001 和 0.05）。胎盘 C20:4n-6/C20:5n-3 和 TXB/6-keto-PGF 比值最高与最低三分位组 NTD 发生率的比值分别为 3.79（95%置信区间，1.60-8.96）（p<0.01）和 5.52（95%置信区间，2.07-14.74）（p<0.001），调整胎儿性别以及母亲年龄、职业、产次、吸烟、被动吸烟、围孕期叶酸补充、受孕季节和饮茶后仍有意义。C20:4n-6/C20:5n-3 比值与 TXB/6-keto-PGF 比值呈正相关（r=0.14；p<0.05）。病例组 C18:2n-6、C18:3n-6、C20:3n-6、C18:3n-3、C20:3n-3、C20:5n-3 和 C22:5n-3 比例明显低于对照组，与 NTD 发生均呈负相关（三分位特定比值比）；调整潜在混杂因素后，除 C20:3n-3 外，这些关联仍有统计学意义（p<0.05）。
结论
高胎盘 C20:4n-6/C20:5n-3 和 TXB/6-keto-PGF 比值是神经管缺陷的危险因素。出生缺陷研究 109：550-563，2017。© 2017 约翰威立父子出版公司
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