China Medical University, Shenyang, Liaoning, China.
Department of Obstetrics, The First Hospital of China Medical University, Shenyang, Liaoning, China.
Biomed Res Int. 2021 May 6;2021:6652231. doi: 10.1155/2021/6652231. eCollection 2021.
Homocysteine (Hct) is a substance produced in the metabolism of methionine. It is an essential type of amino acid gained from the daily diet. Methylenetetrahydrofolate reductase (MTHFR) gene mutation is related to elevated total homocysteine (tHct) expressions, in particular, among women with low folate intake. Hyperhomocysteinemia (HHct) is caused by numerous factors, such as genetic defects, lack of folic acid, vitamin B and B deficiency, hypothyroidism, drugs, aging, and renal dysfunction. Increased Hct in peripheral blood may lead to vascular illnesses, coronary artery dysfunction, atherosclerotic changes, and embolic diseases. Compared to nonpregnant women, the Hct level is lower in normal pregnancies. Recent studies have reported that HHct was associated with numerous pregnancy complications, including recurrent pregnancy loss (RPL), preeclampsia (PE), preterm delivery, placental abruption, fetal growth restriction (FGR), and gestational diabetes mellitus (GDM). Besides, it was discovered that neonatal birth weight and maternal Hct levels were negatively correlated. However, a number of these findings lack consistency. In this review, we summarized the metabolic process of Hct in the human body, the levels of Hct in different stages of normal pregnancy reported in previous studies, and the relationship between Hct and pregnancy complications. The work done is helpful for obstetricians to improve the likelihood of a positive outcome during pregnancy complications. Reducing the Hct level with a high dosage of folic acid supplements during the next pregnancy could be helpful for females who have suffered pregnancy complications due to HHct.
同型半胱氨酸（Hct）是蛋氨酸代谢过程中产生的一种物质。它是一种从日常饮食中获得的必需氨基酸。亚甲基四氢叶酸还原酶（MTHFR）基因突变与总同型半胱氨酸（tHct）升高有关，尤其是在叶酸摄入量低的女性中。高同型半胱氨酸血症（HHct）由多种因素引起，如遗传缺陷、叶酸、维生素 B 和 B 缺乏、甲状腺功能减退、药物、衰老和肾功能不全。外周血中 Hct 的增加可能导致血管疾病、冠状动脉功能障碍、动脉粥样硬化变化和栓塞性疾病。与非妊娠妇女相比，正常妊娠妇女的 Hct 水平较低。最近的研究报告称，HHct 与许多妊娠并发症有关，包括复发性流产（RPL）、子痫前期（PE）、早产、胎盘早剥、胎儿生长受限（FGR）和妊娠期糖尿病（GDM）。此外，还发现新生儿出生体重与母亲 Hct 水平呈负相关。然而，其中许多发现缺乏一致性。在这篇综述中，我们总结了 Hct 在人体中的代谢过程，以及之前研究报道的正常妊娠不同阶段的 Hct 水平，以及 Hct 与妊娠并发症之间的关系。这项工作有助于产科医生提高妊娠并发症期间的积极结果的可能性。对于因 HHct 而遭受妊娠并发症的女性，在下一次妊娠中用高剂量叶酸补充剂降低 Hct 水平可能会有所帮助。
