Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia.
Gynecol Endocrinol. 2021;37(sup1):8-12. doi: 10.1080/09513590.2021.2006451.
To study the relationship between vitamin D deficiency, VDR gene polymorphism rs10735810 (A > G), and a missed abortion in the first trimester of gestation; to determine the predictors of its risk.
178 women aged between 18 and 41 were surveyed. The main group consisted of patients with miscarriage ( = 101), verified at the hospital stage (O02.0; O02.1), which were stratified by I group ( = 58, patients with the first miscarriage) and II groups ( = 43, patients with repeated miscarriage). The control group ( = 77) consisted of women with a successful pregnancy (Z34.0), which subsequently ended in delivery at term with a live fetus. Patients were surveyed and data was extracted from primary medical records. The level of 25(OH)D in the blood serum was investigated by mass spectrometry ( = 99). Genotyping for the vitamin D receptor gene polymorphism rs10735810 (VDR A > G) was performed for 177 patients. Statistical data analysis was performed Statistica 10 and SAS JMP 11 application packages, using single-factor prediction for quantitative and binary factors, ROC analysis, and CHAID decision tree construction.
WE found that patients with miscarriage in the first trimester of gestation ( = 60) more frequently than those in the control group ( = 39) had vitamin D insufficiency (93.3% versus 76.9%, = .0183) including its deficiency, occurring at 25(OH)D of blood <20 ng/ml (71.7% versus 51.3%, = .0392). This pattern was found in patients with the first miscarriage, where significant differences in the frequency of vitamin D deficiency were also detected in comparison with the control group (80.0% versus 51.3%, = .0026). No direct correlation was found between the frequency of miscarriages in the first trimester and the variant of the polymorphism of the vitamin D receptor gene (VDR A > G [rs10735810]); the GG genotype in patients with repeated miscarriages was even less frequent compared to the control group (14.0% versus 23.7%, = .3344). However, the decision tree has identified four risk classes and has determined that the highest risk of missed abortion in the cohort studied is formed by three predicates: smoking, serum level 25(OH) < 6.5 ng/ml and VDR AA and GG genotypes.
The data obtained show that vitamin D insufficiency plays a pathogenetically significant role in early reproductive losses associated with miscarriages, both first and recurrent.
研究维生素 D 缺乏、VDR 基因多态性 rs10735810（A>G）与孕早期稽留流产的关系；确定其风险的预测因子。
调查了 178 名年龄在 18 至 41 岁的女性。主要组由在医院阶段确诊为流产的患者（n=101）组成（O02.0；O02.1），按 I 组（n=58，首次流产患者）和 II 组（n=43，复发性流产患者）分层。对照组（n=77）由成功妊娠的妇女组成（Z34.0），随后足月分娩活产。对患者进行了调查，并从原始病历中提取了数据。通过质谱法（n=99）检测血清 25(OH)D 水平。对 177 例患者进行了维生素 D 受体基因多态性 rs10735810（VDR A>G）的基因分型。使用单因素预测对定量和二元因素进行了统计数据分析，进行了 ROC 分析和 CHAID 决策树构建。
我们发现，与对照组（n=39）相比，孕早期稽留流产患者（n=60）更频繁地出现维生素 D 不足（93.3%对 76.9%，=0.0183），包括其缺乏症，血 25(OH)D<20ng/ml（71.7%对 51.3%，=0.0392）。在首次流产的患者中也发现了这种模式，与对照组相比，维生素 D 缺乏的频率也存在显著差异（80.0%对 51.3%，=0.0026）。在孕早期的流产频率与维生素 D 受体基因多态性（VDR A>G[rs10735810]）的变异之间未发现直接相关性；与对照组相比，复发性流产患者的 GG 基因型甚至更为少见（14.0%对 23.7%，=0.3344）。然而，决策树确定了四个风险等级，并确定在研究队列中，稽留流产的最高风险由三个预测因子形成：吸烟、血清 25(OH)<6.5ng/ml 和 VDR AA 和 GG 基因型。
所得数据表明，维生素 D 不足在与流产相关的早期生殖损失中具有重要的发病机制作用，包括首次和复发性流产。
