Department of General Surgery, Ankara Oncology Hospital, Ankara, Turkey.
Division of Perinatology, Hacettepe University, Ankara, Turkey.
J Invest Surg. 2021 Oct;34(10):1104-1107. doi: 10.1080/08941939.2020.1742402. Epub 2020 Mar 31.
To investigate the relationship of cholelithiasis and urolithiasis with (MTHFR) polymorphism(s) in patients with poor obstetric history to search whether they are risk factors for adverse pregnancy outcome.
This study is consisted of 94 patients with poor obstetric history. Patients were evaluated in terms of the presence of cholelithiasis and urolithiasis in association with MTHFR polymorphism(s). Additional laboratory tests including homocysteine measurements were also performed. ROC analysis for assessing the performance of blood homocysteine level in predicting the presence of cholelithiasis and urolithiasis were also performed.
Patients were divided into three groups such as cholelithiasis group (n = 9, 9.6%), urolithiasis group (n = 18, 19.1%) and control group (n = 67, 71.3%). Groups did not differ in term of age and Beksac obstetrics index (BOI) which is "[living child+(π/10)]/gravidity." The rate of the presence of MTHFR polymorphisms were 88.9% (8/9), 88.9% (16/18) and 43.3% (29/67) in cholelithiasis, urolithiasis and control groups respectively. Median homocysteine levels were found to be 13.1, 11.6 and 7.2 micromol/lt for the groups respectively. Statistically significant differences were found for MTHFR polymorphism rates and homocysteine levels (<0.001 for both). According to ROC analysis, 10.9 mcmol/L (88.9% sensitivity, 89.6% specificity) and 9.25 mcmol/L (83.3% sensitivity, 73.1% specificity) were determined to be cutoff values of homocysteine for cholelithiasis and urolithiasis respectively.
More frequent MTHFR polymorphisms are observed in women with a clinical history of gall or renal stones. Thus, screening of these patients may be benefical for the approprate management of their subsequent pregnancies.
研究有不良妊娠史的患者的胆石病和尿路结石与亚甲基四氢叶酸还原酶（MTHFR）多态性的关系，以探讨其是否为不良妊娠结局的危险因素。
本研究共纳入 94 例有不良妊娠史的患者。评估患者的胆石病和尿路结石与 MTHFR 多态性的存在情况。此外，还进行了包括同型半胱氨酸测量在内的其他实验室检查。还进行了 ROC 分析，以评估血液同型半胱氨酸水平预测胆石病和尿路结石存在的性能。
患者分为胆石病组（n=9，9.6%）、尿路结石组（n=18，19.1%）和对照组（n=67，71.3%）。各组在年龄和 Beksac 产科指数（BOI）方面无差异，BOI 为“[活产儿数+（π/10）]/妊娠次数”。MTHFR 多态性的存在率分别为胆石病组 88.9%（8/9）、尿路结石组 88.9%（16/18）和对照组 43.3%（29/67）。胆石病、尿路结石和对照组的同型半胱氨酸中位数分别为 13.1、11.6 和 7.2 μmol/L。MTHFR 多态性率和同型半胱氨酸水平存在统计学显著差异（均<0.001）。根据 ROC 分析，10.9 mcmol/L（88.9%的敏感性，89.6%的特异性）和 9.25 mcmol/L（83.3%的敏感性，73.1%的特异性）被确定为同型半胱氨酸用于胆石病和尿路结石的截断值。
有胆石病或肾结石临床病史的女性中观察到更频繁的 MTHFR 多态性。因此，对这些患者进行筛查可能有助于对其后续妊娠进行适当管理。
