Martins Russell S, Ahmed Taimur, Farhat Sabah, Shahid Sana, Fatima Syeda Sadia
Medical College, Aga Khan University, Karachi, Sindh 74800, Pakistan.
Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Sindh 74800, Pakistan.
World J Diabetes. 2019 Jul 15;10(7):396-402. doi: 10.4239/wjd.v10.i7.396.
Women with gestational diabetes mellitus have an increased risk of developing gestational hypertension, which can increase fetal and neonatal morbidity and mortality. In the past decade, single nucleotide polymorphisms in several genes have been identified as risk factors for development of gestational hypertension. The epidermal growth factor receptor activates tyrosine kinase mediated blood vessels contractility; and inflammatory cascades. Abnormalities in these mechanism are known to contribute towards hypertension. It is thus plausible that polymorphisms in the epidermal growth factor receptor gene would be associated with the development of hypertension in women with gestational diabetes.
To determine whether the epidermal growth factor receptor rs17337023 SNP is associated with the occurrence of hypertension in gestational diabetic women.
This pilot case-control study was conducted at two tertiary care hospitals in Karachi, from January 2017-August 2018. Two hundred and two women at 28 week of gestation with gestational diabetes were recruited and classified into normotensive ( = 80) and hypertensive ( = 122) groups. Their blood samples were genotyped for epidermal growth factor receptor polymorphism rs17337023 using tetra-ARMS polymerase chain reaction. Descriptive analysis was applied on baseline data. Polymorphism data was analyzed for genotype and allele frequency determination using chi-squared statistics. In all cases, a value of < 0.05 was considered significant.
Subjects were age-matched and thus no difference was observed in relation to age of the study subjects ( >0.05). Body fat percentage was significantly higher in hypertensive females as compared to normotensive subjects (35.138 ± 4.29 Case 25.01 ± 8.28 Control; < 0.05). Similarly, systolic and diastolic blood pressures among groups were significantly higher in hypertensive group than the normotensive group ( < 0.05). Overall epidermal growth factor receptor rs17337023 polymorphism genotype frequency was similar in both groups, with the heterozygous AT genotype (56 in Case 48 in Control; = 0. 079) showing predominance in both groups. Furthermore, the odds ratio for A allele was 1.282 ( = 0.219) and for T allele was 0.780 ( = 0.221) in this study.
This pilot study indicates that polymorphisms in rs17337023 may not be involved in the pathophysiology of gestational hypertension in gestational diabetes inflammatory cascade mechanism. Further large-scale studies should explore polymorphism in epidermal growth factor receptor and other genes in this regard.
妊娠糖尿病女性患妊娠高血压的风险增加，这会增加胎儿和新生儿的发病率及死亡率。在过去十年中，已确定多个基因中的单核苷酸多态性是妊娠高血压发生的风险因素。表皮生长因子受体激活酪氨酸激酶介导的血管收缩以及炎症级联反应。已知这些机制异常会导致高血压。因此，表皮生长因子受体基因的多态性可能与妊娠糖尿病女性高血压的发生有关。
确定表皮生长因子受体rs17337023单核苷酸多态性是否与妊娠糖尿病女性高血压的发生相关。
这项前瞻性病例对照研究于2017年1月至2018年8月在卡拉奇的两家三级护理医院进行。招募了202名妊娠28周的妊娠糖尿病女性，并将其分为血压正常组（n = 80）和高血压组（n = 122）。使用四引物扩增不应性突变系统聚合酶链反应对其血样进行表皮生长因子受体多态性rs17337023基因分型。对基线数据进行描述性分析。使用卡方统计分析多态性数据以确定基因型和等位基因频率。在所有情况下，P值<0.05被认为具有统计学意义。
研究对象年龄匹配，因此在研究对象年龄方面未观察到差异（P>0.05）。与血压正常的受试者相比，高血压女性的体脂百分比显著更高（35.138±4.29病例 vs 25.01±8.28对照；P<0.05）。同样，高血压组的收缩压和舒张压显著高于血压正常组（P<0.05）。两组中表皮生长因子受体rs17337023多态性的总体基因型频率相似，杂合子AT基因型（病例组56例 vs 对照组48例；P = 0.079）在两组中均占主导。此外，本研究中A等位基因的优势比为1.282（P = 0.219），T等位基因的优势比为0.780（P = 0.221）。
这项前瞻性研究表明，rs17337023的多态性可能不参与妊娠糖尿病中妊娠高血压的病理生理过程 炎症级联反应机制。在这方面，进一步的大规模研究应探索表皮生长因子受体和其他基因的多态性。
