Hu Tzu-Yu, Mayasari Noor Rohmah, Cheng Tsai-Mu, Bai Chyi-Huey, Chao Jane C-J, Huang Ya-Li, Wang Fan-Fen, Skalny Anatoly V, Tinkov Alexey A, Chang Jung-Su
School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Xing Street, Taipei, 11031, Taiwan.
Graduate Institute of Translational Medicine, College of Medical Sciences and Technology, Taipei Medical University, Taipei, Taiwan.
Eur J Nutr. 2023 Feb;62(1):299-309. doi: 10.1007/s00394-022-02987-9. Epub 2022 Aug 16.
To assess whether polymorphisms of haptoglobin (Hp) modify the relationship between dietary iron and the risk of gestational iron-deficiency anemia (IDA).
This study analyzed 1430 singleton pregnant women aged 20 ~ ≤ 48 years from the 2017-2019 National Nutrition and Health Survey of Pregnant Women in Taiwan. Sociodemographic, blood biochemical, Hp phenotype, and 24-h dietary recall data were collected. Erythropoiesis-related total prenatal supplementation was defined as the reported use of multivitamins and minerals, vitamin B complex, folate, and iron.
Distributions of the Hp 1-1, Hp 2-1, and Hp 2-2 phenotypes were 13.6, 39.8, and 46.5%, respectively. Women with the Hp 1-1 phenotype had the lowest mean levels of serum ferritin (p-trend = 0.017), the highest prevalence of gestational ID (p-trend = 0.033) as well as the highest prevalence of gestational IDA (did not reach statistical differences, p-trend = 0.086). A gene-diet interaction on serum ferritin was observed between the Hp 1 and Hp 2 (2-1/2-2) alleles (p < 0.001). An adjusted multivariate logistic regression showed that compared to those with a normal blood iron status and who reported using erythropoiesis-related total prenatal supplements, those who did not had a 4.05-fold [odds ratio (OR) = 4.05 (95% confidence interval (CI) 2.63-6.24), p < 0.001] increased risk of gestational IDA. The corresponding ORs for carriers of the Hp 1 and Hp 2 alleles were 4.78 (95% CI 1.43-15.99) and 3.79 (95% CI 2.37-6.06), respectively.
Pregnant women who are Hp 1 carriers are at increased risk for developing IDA if they do not meet the recommended dietary allowance for iron or use erythropoiesis-related prenatal supplements.
评估触珠蛋白（Hp）基因多态性是否会改变膳食铁与妊娠期缺铁性贫血（IDA）风险之间的关系。
本研究分析了来自2017 - 2019年台湾地区孕妇全国营养与健康调查的1430名单胎孕妇，年龄在20至48岁之间。收集了社会人口统计学、血液生化、Hp表型和24小时膳食回忆数据。促红细胞生成相关的产前总补充剂定义为报告使用的多种维生素和矿物质、复合维生素B、叶酸和铁。
Hp 1-1、Hp 2-1和Hp 2-2表型的分布分别为13.6%、39.8%和46.5%。Hp 1-1表型的女性血清铁蛋白平均水平最低（p趋势 = 0.017），妊娠期铁缺乏（ID）患病率最高（p趋势 = 0.033），妊娠期IDA患病率也最高（未达到统计学差异，p趋势 = 0.086）。在Hp 1和Hp 2（2-1/2-2）等位基因之间观察到血清铁蛋白存在基因-饮食相互作用（p < 0.001）。校正后的多因素逻辑回归显示，与血液铁状态正常且报告使用促红细胞生成相关产前补充剂的孕妇相比，未使用者患妊娠期IDA的风险增加4.05倍[比值比（OR）= 4.05（95%置信区间（CI）2.63 - 6.24），p < 0.001]。Hp 1和Hp 2等位基因携带者的相应OR分别为4.78（95% CI 1.43 - 15.99）和3.79（95% CI 2.37 - 6.06）。
如果不满足铁的推荐膳食摄入量或未使用促红细胞生成相关的产前补充剂，Hp 1基因携带者的孕妇患IDA的风险会增加。
