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Alfaleh A, Alkattan A, Mahmoud N, Alfaleh F, Almutair N, Alanazi A, Kbbash I, Radwan N. The Association Between MTHFR C677T Gene Polymorphism and Repeated Pregnancy Loss in Arabic Countries: a Systematic Review and Meta-Analysis. Reprod Sci 2023; 30:2060-2068. [PMID: 36854824 DOI: 10.1007/s43032-023-01201-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/12/2023] [Indexed: 03/02/2023]
Abstract
The role of MTHFR C677T polymorphism in repeated pregnancy loss (RPL) among different populations has been studied with inconsistent results. The study objective was to determine the association between MTHFR C677T polymorphisms and RPL among Arab women. The review included all the available studies investigating the association between MTHFR C677T polymorphism and RPL from 2000 until now. The searched database included Cochrane, Trip, EMBASE, and Google Scholar. Two authors independently reviewed the searched articles for eligibility, judged their risk of bias, and extracted the characteristics of the studies. Review Manager 5.3 program was used for data analysis using odds ratio (OR) at a 95% confidence interval (CI). The study revealed a statistically significant difference between cases and controls regarding combined MTHFR C677T polymorphisms (OR = 1.50, 95% CI = 1.15-1.96), MTHFR C677T heterozygous (OR = 1.41, 95% CI = 1.08-1.83), and MTHFR C677T homozygous (OR = 4.19, 95% CI = 1.87-9.39). Considerable significant heterogeneity was recorded in the three analyses (P < 0.05). The review supported the hypothesis that MTHFR C677T mutation is considered a significant risk factor for RPL among Arab women.
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Affiliation(s)
- Amjad Alfaleh
- Research and Planning Unit, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia.
| | - Abdullah Alkattan
- Research and Planning Unit, General Directorate of School Health, Ministry of Health, Riyadh, Saudi Arabia.
| | - Nagla Mahmoud
- Department of Research, Assisting Deputyship for Primary Health Care, Ministry of Heath, Riyadh, Saudi Arabia
| | - Fatimah Alfaleh
- Department of Family Medicine, Quizah Primary Healthcare Center, Ministry of Heath, Jeddah, Saudi Arabia
| | - Nasser Almutair
- Urology Department, Al-Iman General Hospital, Ministry of Heath, Riyadh, Saudi Arabia
| | - Amjad Alanazi
- Department of Research, Assisting Deputyship for Primary Health Care, Ministry of Heath, Riyadh, Saudi Arabia
| | - Ibrahim Kbbash
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nashwa Radwan
- Department of Research, Assisting Deputyship for Primary Health Care, Ministry of Heath, Riyadh, Saudi Arabia
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
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Wen Y, He H, Zhao K. Thrombophilic gene polymorphisms and recurrent pregnancy loss: a systematic review and meta-analysis. J Assist Reprod Genet 2023; 40:1533-1558. [PMID: 37248348 PMCID: PMC10352225 DOI: 10.1007/s10815-023-02823-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/29/2023] [Indexed: 05/31/2023] Open
Abstract
PURPOSE Recurrent pregnancy loss (RPL) is affecting 1-4% of women who conceive approximately, and no cause could be found in more than 50% of women suffering from RPL. Inherited thrombophilias have got increasing attention in women with unexplained RPL, so we aim to explore the relationship among these most common thrombophilic polymorphisms and RPL through a literature review and meta-analysis. METHODS Observational studies from PubMed, Embase, Cochrane, and Web of Science from 1997 to 7 April 2022 were searched. For each genetic variant, a fixed or random-effect model was used according to the heterogeneity test to calculate pooled ORs and 95% CIs for both dominant and recessive genetic models. Egger's line regression test was used to assess publication bias. The quality of the included articles was assessed by the Newcastle Ottawa scale. RESULTS A total of 124 articles comprising 17,278 RPL patients and 16,021 controls were included. Results showed that hyperhomocysteinemia (MTHFR) C677T (dominant model: OR, 1.43; 95% CI, 1.25-1.64; recessive model: OR, 1.60; 95% CI, 1.36-1.87), MTHFR A1298C (dominant model: OR, 1.66; 95% CI, 1.26-2.18; recessive model: OR, 1.79; 95% CI, 1.42-2.26), PAI-1 4G/5G (dominant model: OR, 1.67; 95% CI, 1.36-2.06; recessive model: OR, 1.80; 95% CI, 1.39-2.32), angiotensin-converting enzyme I/D (OR, 1.23; 95% CI, 1.00-1.53), Factor XIII V34L (OR, 1.38; 95% CI, 1.02-1.87), and β-fibrinogen-455G/A (OR, 1.60; 95% CI, 1.02-2.51) were significantly associated with RPL. CONCLUSION This study provides potentially useful clinical markers to evaluate the risk of RPL or to help unexplained RPL patients identify possible causes, which may allow for targeted treatment.
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Affiliation(s)
- Yuanjia Wen
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haodong He
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Nguyen Ngoc N, Tran Ngoc Thao M, Trieu Tien S, Vu Tung S, Le H, Ho Sy H, Nguyen Thanh T, Trinh The S. Evaluating the Association Between Genetic Polymorphisms Related to Homocysteine Metabolism and Unexplained Recurrent Pregnancy Loss in Women. Appl Clin Genet 2022; 15:55-62. [PMID: 35698663 PMCID: PMC9188402 DOI: 10.2147/tacg.s365281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the relationship between unexplained recurrent pregnancy loss (URPL) and polymorphisms of homocysteine metabolism-related genes in women. Materials and Methods A case-control study included 90 women with two or more consecutive unexplained pregnancy losses and 92 controlled women without miscarriage history; the female participants were in the age category of 18-35 years. The high-resolution melting technique was used to detect the single-nucleotide variants related to homocysteine metabolism disorder, namely MTHFR C677T, MTHFR A1298C, MTR A2756G, and MTRR A66G polymorphism. Results The MTHFR C677T polymorphism had significantly correlation with URPL. Indeed, the frequency of the677T allele and genotypes (677CT, 677TT) in the URPL group was significantly higher than that in the control group (p < 0.05). However, the allele, as well as genotype distribution of MTHFR A1298C, MTR A2756G, and MTRR A66G polymorphisms showed no significant difference (p > 0.05). MTHFR 677CT-1298AC genotype combination led to a 9.0-fold increased risk of URPL (OR 9.0; 95% CI, 2.25-35.99; p = 0.001), while the risk increased 10.0-fold (OR 10.0; 95% CI, 1.8-55.53; p = 0.008) when participants had more than the 3 variant loci. Conclusion The MTHFR C677T polymorphism was a risk factor for URPL, and determining the MTHFR C677T polymorphism had a potential prediction of URPL risk. Moreover, the MTHFR C677T and MTHFR A1298C joint mutants might have a synergistic effect on URPL. Conversely, there is a lack of evidence suggesting the URPL risk of MTHFR A1298C, MTR A2756G, and MTRR A66G polymorphisms.
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Affiliation(s)
- Nhat Nguyen Ngoc
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 12108, Vietnam
| | - My Tran Ngoc Thao
- Département de formation Biologie moléculaire et cellulaire, Sorbonne University, Paris, 75006, France
| | - Sang Trieu Tien
- Department of Biology and Genetics, Vietnam Military Medical University, Hanoi, 12108, Vietnam
| | - Son Vu Tung
- Department of Epidemiology, Vietnam Military Medical University, Hanoi, 12108, Vietnam
| | - Hoang Le
- IVFTA, Tam Anh General Hospital, Hanoi, 100000, Vietnam
| | - Hung Ho Sy
- Department of Obstetrics and Gynecology, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Tung Nguyen Thanh
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 12108, Vietnam
| | - Son Trinh The
- Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, 12108, Vietnam
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Amin YK. Single-nucleotide polymorphisms in MTHFR gene related to recurrent abortion. APPLIED NANOSCIENCE 2021. [DOI: 10.1007/s13204-021-01959-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shaker MM, Shalabi TA, Amr KS. Correlation of methylation status in MTHFR promoter region with recurrent pregnancy loss. J Genet Eng Biotechnol 2021; 19:44. [PMID: 33751263 PMCID: PMC7984131 DOI: 10.1186/s43141-021-00147-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 12/16/2022]
Abstract
Background DNA methylation is an epigenetic process for modifying transcription factors in various genes. Methylenetetrahydrofolate reductase (MTHFR) stimulates synthesis of methyl radical in the homocysteine cycle and delivers methyl groups needed in DNA methylation. Furthermore, numerous studies have linked gene polymorphisms of this enzyme with a larger risk of recurrent pregnancy loss (RPL), yet scarce information is available concerning the association between epigenetic deviations in this gene and RPL. Hypermethylation at precise DNA sequences can function as biomarkers for a diversity of diseases. We aimed by this study to evaluate the methylation status of the promoter region of MTHFR gene in women with RPL compared to healthy fertile women. It is a case–control study. Hundred RPL patients and hundred healthy fertile women with no history of RPL as controls were recruited. MTHFR C677T was assessed by polymerase chain reaction-restriction fragment length polymorphism (RFLP). Quantitative evaluation of DNA methylation was performed by high-resolution melt analysis by real-time PCR. Results The median of percentage of MTHFR promoter methylation in RPL cases was 6.45 [0.74–100] vs. controls was 4.50 [0.60–91.7], P value < 0.001. In the case group, 57 hypermethylated and 43 normo-methylated among RPL patients vs. 40 hypermethylated and 60 normo-methylated among controls, P< 0.005. Frequency of T allele in C677T MTHFR gene among RPL patients was 29% vs. 23% among the control group; C allele vs. T allele: odds ratio (OR) = 1.367 (95% confidence interval (CI) 0.725–2.581). Conclusion Findings suggested a significant association between hypermethylation of the MTHFR promoter region in RPL patients compared to healthy fertile women.
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Affiliation(s)
- Mai Mahmoud Shaker
- Prenatal and Fetal Medicine Department, Human Genetics and Genome Research Division, National Research Centre, 33 El Buhooth St, Dokki, Cairo, Egypt.
| | - Taghreed Abdelmoniem Shalabi
- Prenatal and Fetal Medicine Department, Human Genetics and Genome Research Division, National Research Centre, 33 El Buhooth St, Dokki, Cairo, Egypt
| | - Khalda Said Amr
- Medical Molecular Genetics Department, Human Genetics and Genome Research Division, National Research Centre, 33 El Buhooth St, Dokki, Cairo, Egypt
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Mehta P, Vishvkarma R, Singh K, Rajender S. MTHFR 1298A>C Substitution is a Strong Candidate for Analysis in Recurrent Pregnancy Loss: Evidence from 14,289 Subjects. Reprod Sci 2021; 29:1039-1053. [PMID: 33742421 DOI: 10.1007/s43032-021-00530-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Abstract
We undertook meta-analyses on MTHFR 1298A>C substitution for critically evaluating its association with recurrent pregnancy loss (RPL). MTHFR genotype data for 5888 cases and 8401 controls from 39 studies were pooled to perform this meta-analyses. Genotype data were screened, scrutinized, pooled, analysed and subjected to sensitivity analysis to carefully evaluate the association between MTHFR 1298A>C and recurrent pregnancy loss. Genetic associations were sought using dominant, recessive and co-dominant models of genetic testing with odds ratio and 95% Confidence interval (CI) as the effect measures. Further analyses were undertaken by classifying the studies into Caucasian and East Asian sub-groups. Genetic heterogeneity was tested before pooling the data across studies. For assessing publication bias, Egger's intercept test was undertaken. We found a significant association of 1298A>C substitution with increased risk of RPL in the dominant (P=0.000; OR = 1.58; 95% CI =1.25-1.99) as well as recessive (P=0.000; OR = 1.66; 95% CI =1.25-2.20) models. In sub-group analysis, we observed a significant association of the polymorphism with RPL in the Caucasian populations using dominant (P=0.000; OR = 1.98; 95% CI =1.42-2.76) and recessive (P=0.000; OR = 2.20; 95% CI =1.49-3.24) models. However, this substitution showed no association with RPL in the East Asian populations (P=0.149; OR = 1.187; 95% CI =0.94-1.50). MTHFR 1298A>C substitution shows association with the risk of recurrent pregnancy loss. The association is in a population-specific manner with the substitution being a strong risk factor only in the Caucasian populations.
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Affiliation(s)
- Poonam Mehta
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India
| | - Rahul Vishvkarma
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India
| | | | - Singh Rajender
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India.
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Zhao X, Zhao Y, Ping Y, Chen L, Feng X. Association between gene polymorphism of folate metabolism and recurrent spontaneous abortion in Asia: A Meta-analysis. Medicine (Baltimore) 2020; 99:e21962. [PMID: 33019388 PMCID: PMC7535684 DOI: 10.1097/md.0000000000021962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
To evaluate the association between gene polymorphisms of MTHFR (C677T, A1298C) and MTRR (A66G), and the recurrent spontaneous abortion (RSA) risk in Asia.Related case-control studies were collected, selected, and screened. A meta-analysis was conducted by Stata 12.0 software to assess the association between polymorphisms of target genes and RSA.Altogether 30 studies examining the relationship between genetic polymorphism of folate metabolism and RSA risk were included, among which 20 studies were related to MTHFR C677T, 11 to MTHFR A1298C and 6 to MTRR A66G. The studies suggested that MTHFR C677T polymorphism was closely connected with RSA risk under all models (P < .05). Furthermore according to the subgroup analysis of ethnicity, the correlation between C677T polymorphism and RSA was stronger in north of China when compared with south of China and other Asian countries (P > . 05). For MTHFR A1298C, it was closely related to RSA risk in all gene models except for (AC vs AA) (P < .05). However, when it comes to MTRR A66G, there was no significant correlation between gene A66G polymorphism and RSA risk except for the additive gene model (G vs A) (P < .05).The present evidence shows that the correlation between gene polymorphisms and RSA risk can be found in MTHFR C677T, A1298C (except for heterozygote model) and MTRR A66G (only in additive genotypes), and the detection of the correlated gene polymorphisms mentioned above is of certain guiding significance for preventing RSA and screening high-risk groups.
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Affiliation(s)
- Xiaoxuan Zhao
- Department of Heilongjiang University of Chinese Medicine, Harbin
| | - Yang Zhao
- Hebei College of Traditional Chinese Medicine, Shijiazhuang
| | - Yunlu Ping
- Department of Heilongjiang University of Chinese Medicine, Harbin
| | - Lu Chen
- Department of First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaoling Feng
- Department of First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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Impact of RFC1, MTHFR, and MTHFD1 polymorphism on unexplained pregnancy loss (UPL): comparative analysis of maternal and fetal components using mother-abortus paired samples. Eur J Obstet Gynecol Reprod Biol 2018; 231:152-157. [PMID: 30388610 DOI: 10.1016/j.ejogrb.2018.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/17/2018] [Accepted: 09/10/2018] [Indexed: 11/24/2022]
Abstract
In this study, we aimed to investigate associations between polymorphisms of folate metabolic pathway genes and unexplained pregnancy loss (UPL) using matched maternal-fetal samples. A total of 113 mother-abortus and 92 mother-newborn samples were collected. Among the 113 mother-abortus samples, 50 with chromosomal abnormality and 22 with maternal cell contamination were excluded. Samples were genotyped for RFC-1 80A>G, MTHFD1 1958 G>A, MTHFR 677C>T, and MTHFR 1298A>C polymorphisms using restriction fragment length polymorphism markers. The genotypes of RFC-1 80A>G, MTHFD1 1958 G>A, MTHFR 677C>T, and MTHFR 1298A>C were not associated with UPL in maternal samples. In the fetal samples, the frequency of heterozygous genotype (GA) of MTHFD11958 G>A was significantly higher than that that of the control (OR = 2.477, 95% CI = 1.128-5.446, p = 0.037). The AA-GA genotypes of MTHFD1 1958G>A and RFC-1 80A>G were significantly higher in mother-abortus samples (p = 0.016) than in the mother-newborn samples (p = 0.029). Frequencies of allelic combinations of MTHFR 677C>T/MTHFD11958G>A and RFC-1 80A>G/MTHFR677C>T/MTHFD1 1958G>A were significantly higher in maternal samples of the UPL group. In the fetal samples, no significant differences were detected between the UPL group and the control group. This study is the first to show associations between MTHFD1 1958G>A, RFC-1 80G>A, MTHFR 677C>T, and MTHFR 1298A>C polymorphisms and UPL and to compare the effects of maternal and fetal samples on UPL using mother-abortus matched samples of Korean origin.
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Vidyadhari M, Sujatha M, Krupa P, Nallari P, Venkateshwari A. A family based triad study evaluating the role of MTHFR gene polymorphisms in spontaneous abortions. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dell'Edera D, L'Episcopia A, Simone F, Lupo MG, Epifania AA, Allegretti A. Methylenetetrahydrofolate reductase gene C677T and A1298C polymorphisms and susceptibility to recurrent pregnancy loss. Biomed Rep 2018; 8:172-175. [PMID: 29435277 DOI: 10.3892/br.2018.1039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/24/2017] [Indexed: 01/26/2023] Open
Abstract
Several studies have investigated the link between two different polymorphisms (C677T and A1298T) of the gene encoding methylenetetrahydrofolate reductase (MTHFR) and the risk of recurrent pregnancy loss (RPL); however, the results remain controversial. This study aimed to provide greater insight into this debated topic. In the current study, two groups of pregnant women (group A: RPL women; group B: non-RPL women), each of which were subdivided further into two subgroups based on their gestational age, were screened for C677T and A1298T variants of the MTHFR gene. The resulting data were analyzed using receiver operating characteristic (ROC) curve and Z test methods to compare the two groups. These ROC curve and Z test analyses indicated that there were no differences between the groups regarding C677T and A1298T expression. RPL is primarily caused by mutations in prothrombin or factor V Leiden genes. However, a low percentage of RPL cannot be attributed to these mutations. In the last five years, research has focused on the MTHFR gene, the two major variants of which (C677T and A1298T) have been associated with an increased risk of cardiovascular diseases (thrombotic events) in homozygous individuals. In addition, these mutations may be related to an increased rate of neural tube defects in fetuses. While a link between MTHFR mutation and RPL may be expected based on previous findings, the present study indicated the absence of an association between the polymorphisms of the MTHFR gene and RPL risk.
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Affiliation(s)
- Domenico Dell'Edera
- Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, I-75100 Matera, Italy
| | - Antonella L'Episcopia
- Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, I-75100 Matera, Italy
| | - Francesca Simone
- Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, I-75100 Matera, Italy
| | - Maria Giovanna Lupo
- Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, I-75100 Matera, Italy
| | - Annunziata Anna Epifania
- Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, I-75100 Matera, Italy
| | - Arianna Allegretti
- Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, I-75100 Matera, Italy
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Hwang KR, Choi YM, Kim JJ, Lee SK, Yang KM, Paik EC, Jeong HJ, Jun JK, Yoon SH, Hong MA. Methylenetetrahydrofolate Reductase Polymorphisms and Risk of Recurrent Pregnancy Loss: a Case-Control Study. J Korean Med Sci 2017; 32:2029-2034. [PMID: 29115087 PMCID: PMC5680504 DOI: 10.3346/jkms.2017.32.12.2029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/09/2017] [Indexed: 12/02/2022] Open
Abstract
The balance between coagulation and fibrinolysis is an essential part in early pregnancy. Mutations in methylenetetrahydrofolate reductase (MTHFR) gene lead to decreased activity of the enzyme and hyperhomocysteinemia, which then induces platelet aggregation by promoting endothelial oxidative damage, possibly resulting in adverse effect on maintenance of pregnancy. We investigated the role of MTHFR single nucleotide polymorphisms (SNPs), C677T and A1298C, in Korean patients with recurrent pregnancy loss (RPL). We conducted a prospective case-control study in the Korean population. Subjects included 302 women with 2 or more consecutive, unexplained, spontaneous miscarriages before 20 weeks of gestation and 315 control women without a history of recurrent miscarriages. The genotyping for C677T and A1298C polymorphisms was performed using the TaqMan assay. Continuous variables were compared using Student's t-test, and χ² test was used to evaluate differences in the genotype distributions between the RPL and the controls. The genotype distribution of both polymorphisms in the RPL group did not differ from those of the controls. For further analysis, if RPL patients were divided according to the numbers of pregnancy losses (≥ 2 and ≥ 3) neither group was significantly different compared with controls. MTHFR gene C677T and A1298C polymorphisms are not associated with idiopathic RPL in Korean women, suggesting that those may not be susceptible allelic variants or be deficient to cause RPL.
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Affiliation(s)
- Kyu Ri Hwang
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Young Min Choi
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- The Institute of Reproductive Medicine and Population, Medical Research Centre, Seoul National University College of Medicine, Seoul, Korea.
| | - Jin Ju Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Sung Ki Lee
- Department of Obstetrics and Gynecology, Konyang University College of Medicine, Daejeon, Korea
| | - Kwang Moon Yang
- Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University, College of Medicine, Seoul, Korea
| | - Eun Chan Paik
- Department of Obstetrics and Gynecology, Bundang Cheil Women's Hospital, Sungnam, Korea
| | - Hyeon Jeong Jeong
- Department of Obstetrics and Gynecology, Seoul Rachel Fertility Center, Seoul, Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Ho Yoon
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University, Seoul, Korea
| | - Min A Hong
- The Institute of Reproductive Medicine and Population, Medical Research Centre, Seoul National University College of Medicine, Seoul, Korea
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Nursal AF, Kaya S, Sezer O, Karakus N, Yigit S. MTHFR gene C677T and A1298C variants are associated with FMF risk in a Turkish cohort. J Clin Lab Anal 2017; 32. [PMID: 28543752 DOI: 10.1002/jcla.22259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/18/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Methylenetetrahydrofolate reductase (MTHFR) is a crucial enzyme in homocysteine (Hcy) metabolism. We aimed to evaluate a possible relationship between MTHFR gene C677T (rs 1801133), A1298C (rs 1801131) variants and susceptibility to FMF in a Turkish cohort. MATERIAL-METHODS This case-control study included 198 Turkish FMF patients and 100 healthy subjects as controls. MTHFR C677T and A1298C were analyzed by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) methods. RESULTS The genotype distribution and allele frequency of the MTHFR C677T were statistically different between the patients and the control group (P=.006, P=.001, respectively). The frequency of the TT genotype and T allele of MTHFR C677T was significantly higher in the patients than in the controls. The genotype distribution of MTHFR A1298C variant did not show any statistically significant difference between the patients and the controls (P›.05). The patients had statistically different frequencies in allele C of MTHFR A1298C variant compared with the control (P=.032). We also examined the risk associated with inheriting the combined genotypes for the two MTHFR variants. According to these results, individuals who were CC homozygous at C677T locus and AA homozygous at A1298C locus have a lower risk of developing FMF (P=.002). Individuals who were TT homozygous at C677T locus and AC heterozygous at A1298C locus have higher risk of developing FMF (P=.033). CONCLUSION Our findings clearly showed there was an association the MTHFR C677T/A1298C variants and susceptibility to FMF in the Turkish sample.
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Affiliation(s)
- Ayse Feyda Nursal
- Faculty of Medicine, Department of Medical Genetic, HititUniversity, Corum, Turkey
| | - Süheyla Kaya
- Faculty of Medicine, Department of Internal Medicine, Gaziosmapasa University, Tokat, Turkey
| | - Ozlem Sezer
- Deparment of Medical Genetics, Samsun Training and Research Hospital, Genetic Clinics, Samsun, Turkey
| | - Nevin Karakus
- Faculty of Medicine, Deparment of Medical Biology, Gaziosmanpasa University, Tokat, Turkey
| | - Serbulent Yigit
- Faculty of Medicine, Deparment of Medical Biology, Gaziosmanpasa University, Tokat, Turkey
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Rai V. Methylenetetrahydrofolate Reductase C677T Polymorphism and Recurrent Pregnancy Loss Risk in Asian Population: A Meta-analysis. Indian J Clin Biochem 2016; 31:402-13. [PMID: 27605737 DOI: 10.1007/s12291-016-0554-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 01/20/2016] [Indexed: 01/15/2023]
Abstract
The C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene was implicated to be associated with thrombophilia due to its role in catalyzing the formation of 5-methylenetetrahydrofolate, a co-substrate for the conversion of homocysteine to methionine. Several case-control studies were investigated MTHFR C677T polymorphism as risk for recurrent pregnancy loss (RPL). These studies rendered contradictory results, some indicating that the polymorphism is associated with the risk of RPL whereas others concluded there is no association. To shed light on these inconclusive findings, a meta-analysis of all available studies published from Asian population relating the C677T polymorphism to the risk of RPL was conducted. The following electronic databases were searched without language restrictions: PubMed, Google Scholars, Elsevier and Springer Link up to December, 2015. Meta-analysis was performed using MetaAnalyst and Mix version 1.7. Meta-analysis results suggested that MTHFR C677T polymorphism contributed to the increased RPL risk in Asian population using all five genetic models (for T vs. C: OR 1.35, 95 % CI 1.09-1.68, p = 0.009; for TT + CT vs. CC: OR 1.44, 95 % CI 1.14-1.82, p = 0.006; for CT vs. CC: OR 1.39, 95 % CI 1.07-1.8, p = 0.01; for TT vs. CC: OR 1.79, 95 % CI 1.23.2.6, p = 0.007; for TT vs. CT + CC: OR 1.61, 95 % CI 1.02-2.56, p = 0.04). In conclusion, this meta-analysis demonstrates a strong association between the MTHFR C677T variant and RPL in Asian population and raising the importance of the use of folate in its treatment and prevention.
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Affiliation(s)
- Vandana Rai
- Human Molecular Genetics Laboratory, Department of Biotechnology, VBS Purvanchal University, Jaunpur, UP 222003 India
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14
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Yang Y, Luo Y, Yuan J, Tang Y, Xiong L, Xu M, Rao X, Liu H. Association between maternal, fetal and paternal MTHFR gene C677T and A1298C polymorphisms and risk of recurrent pregnancy loss: a comprehensive evaluation. Arch Gynecol Obstet 2015; 293:1197-211. [DOI: 10.1007/s00404-015-3944-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 10/23/2015] [Indexed: 11/24/2022]
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15
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Uvarova MA, Ivanov AV, Dedul AG, Sheveleva TS, Komlichenko EV. The effect of single nucleotide genetic polymorphisms of folic acid cycle on the female reproductive system disorders. Gynecol Endocrinol 2015. [DOI: 10.3109/09513590.2015.1086504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Farahmand K, Totonchi M, Hashemi M, Reyhani Sabet F, Kalantari H, Gourabi H, Mohseni Meybodi A. Thrombophilic genes alterations as risk factor for recurrent pregnancy loss. J Matern Fetal Neonatal Med 2015; 29:1269-73. [PMID: 26135458 DOI: 10.3109/14767058.2015.1044431] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The important polymorphisms leading to inherited thrombophilia are Factor V Leiden (FVL), Prothrombin G20210A and MTHFR C677T and A1298C. The frequencies also the correlation among these polymorphisms and RPL have been reported controversially in various populations. Our clinic is one of the referral centers in reproductive biomedicine in which patients in all over Iran refer to; thus the results of this study could be considered clinically beneficial. Besides, in the present study, not only the frequency of specific but also multiple thrombophilic gene alterations were compared in Iranian women with RPL and a control group. METHODS The patients group comprised 330 women with three or more consecutive RPLs. The control population included 350 women with at least one child and no history of pregnancy loss. FVL, Prothrombin G20210A and MTHFR C677T polymorphisms were analyzed by Strip assay kit. MTHFR A1298C was genotyped by PCR-RFLP. RESULTS The frequencies of FVL, Prothrombin G20210A, MTHFR C677T and MTHFR A1298C mutations in patients were 8.48, 4.24, 45.45 and 59.39%, and in controls were 2.86, 2.86, 34.28 and 6%, respectively. CONCLUSIONS The present data showed that FVL, MTHFR polymorphisms also combined with thrombophilic gene mutations have a strong association with RPL.
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Affiliation(s)
- Kamelia Farahmand
- a Department of Genetics , Tehran Medical Sciences Branch, Islamic Azad University , Tehran , Iran and
| | - Mehdi Totonchi
- b Department of Genetics at Reproductive Biomedicine Research Center , Royan Institute for Reproductive Biomedicine , ACECR , Tehran , Iran
| | - Mehrdad Hashemi
- a Department of Genetics , Tehran Medical Sciences Branch, Islamic Azad University , Tehran , Iran and
| | - Fakhreddin Reyhani Sabet
- a Department of Genetics , Tehran Medical Sciences Branch, Islamic Azad University , Tehran , Iran and
| | - Hamid Kalantari
- b Department of Genetics at Reproductive Biomedicine Research Center , Royan Institute for Reproductive Biomedicine , ACECR , Tehran , Iran
| | - Hamid Gourabi
- b Department of Genetics at Reproductive Biomedicine Research Center , Royan Institute for Reproductive Biomedicine , ACECR , Tehran , Iran
| | - Anahita Mohseni Meybodi
- b Department of Genetics at Reproductive Biomedicine Research Center , Royan Institute for Reproductive Biomedicine , ACECR , Tehran , Iran
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17
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Luo L, Chen Y, Wang L, Zhuo G, Qiu C, Tu Q, Mei J, Zhang W, Qian X, Wang X. Polymorphisms of Genes Involved in the Folate Metabolic Pathway Impact the Occurrence of Unexplained Recurrent Pregnancy Loss. Reprod Sci 2014; 22:845-51. [PMID: 25544674 DOI: 10.1177/1933719114565033] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Low levels of folate combined with high levels of homocysteine may cause unexplained recurrent pregnancy loss (URPL). However, the relationships between polymorphisms in genes of the folate metabolic pathway and URPL remain controversial. We conducted a case-control study to explore polymorphisms of the major folate pathway genes, including methylenetetrahydrofolate reductase (MTHFR) 677C>T, MTHFR 1298A>C, methionine synthase (MTR) 2756A>G, methionine synthase reductase (MTRR) 66A>G and reduced folate carrier 1 (RFC-1) 80A>G, and their associations with URPL. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine the distributions of MTHFR, MTR and RFC-1 polymorphisms, and the results were validated using direct sequencing. The polymorphisms in MTRR were determined using direct sequencing. Haplotypes were analyzed using SHEsis, an online tool for biological analysis. We found that the MTHFR 677T allele and the 677T/1298A/2756A/66A/80G haplotype were risk factors for URPL, while the MTR 2756G allele and the 677C/1298A/2756A/66A/80A haplotype exhibited protective effects on susceptibility to URPL in a Chinese Han population from the Hangzhou area.
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Affiliation(s)
- Li Luo
- School of Laboratory Medicine & Life Science, Wenzhou Medical University, Wenzhou, China
| | - Yueming Chen
- Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Li Wang
- Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Guangchao Zhuo
- Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Chunning Qiu
- Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Qiaofeng Tu
- Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China
| | - Jin Mei
- Department of Obstetrics/Gynaecology and Genetics, Hangzhou First People's Hospital, Hangzhou, China
| | - Wen Zhang
- Department of Obstetrics/Gynaecology and Genetics, Hangzhou First People's Hospital, Hangzhou, China
| | - Xia Qian
- Department of Obstetrics/Gynaecology and Genetics, Hangzhou First People's Hospital, Hangzhou, China
| | - Xianjun Wang
- School of Laboratory Medicine & Life Science, Wenzhou Medical University, Wenzhou, China Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China
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18
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MTHFR C677T and A1298C Genotypes and Haplotypes in Slovenian Couples with Unexplained Infertility Problems and in Embryonic Tissues from Spontaneous Abortions. Balkan J Med Genet 2013; 16:31-40. [PMID: 24265582 PMCID: PMC3835294 DOI: 10.2478/bjmg-2013-0015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to analyze the methylenetetrahydrofolate reductases (
MTHFR
s) C677T and A1298C genotype distributions in couples with unexplained fertility problems (UFP) and healthy controls, and to analyze the genotype and haplotype distribution in spontaneously aborted embryonic tissues (SAET) using allele specific polymerase chain reaction (PCR) in 200 probands with UFP, 353 samples of SAET and 222 healthy controls. The analysis revealed a significant overall representation of the 677T allele in male probands from couples with UFP (
p
= 0.036). The combined genotype distribution for both
MTHFR
polymorphisms was also significantly altered (χ
2
21.73, p <0.001) although female probands made no contribution (χ
2
1.33,
p
= 0.72). The overall representation of the 677T allele was more pronounced in SAET (0.5
vs.
0.351 in controls,
p
<0.001) regardless of the karyotype status (aneuploidy
vs.
normal karyotype). In addition, the frequencies of the CA and CC haplotypes were significantly lower than in the control group (
p
= 0.021 and
p
= 0.001, respectively), whereas the frequency of the TC haplotype was significantly higher than in controls (
p
<0.0001). The presented findings indicate that only male probands contribute to the association of
MTHFR
mutations with fertility problems in grown adults and demonstrate a high prevalence of mutated
MTHFR
genotypes in SAET.
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19
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Polymorphisms in MTHFR, MTHFD, and PAI-1 and recurrent miscarriage among North Indian women. Arch Gynecol Obstet 2013; 288:1171-7. [PMID: 23685927 DOI: 10.1007/s00404-013-2877-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the association between MTHFR C677T, A1298C, MTHFD G1958A and plasminogen activator inhibitor type 1 (PAI-1) 4G/5G polymorphism among first trimester recurrent miscarriages. MATERIALS AND METHODS DNA was extracted from peripheral blood samples from 200 patients and 300 controls. Polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) and sequencing were used to identify the polymorphisms. We have analyzed the frequencies, odds ratio, Hardy-Weinberg equilibrium. RESULTS MTHFR C677T, A1298C, and MTHFD G1958A variant alleles were found to be significantly more prevalent in patients than control. However, variant genotype of MTHFR C677T (OR = 2.54; 95 % CI = 1.23-5.24; p value = 0.014), 1298C (OR = 2.23; 95 % CI = 1.09-4.52; p value = 0.028), and MTHFD-1958 showed significant association with pregnancy loss (OR = 2.36; 95 % CI = 1.39-4.02; p value = 0.002). Both MTHFR 677 and MTHFD 1958 showed susceptible effect under recessive model of inheritance. PAI-1 mutations showed no significance. CONCLUSION We observed significant susceptible effects of MTHFR C677T, A1298C, and MTHFD G1958A among RM cases. Our data points toward the multifactorial nature of the recurrent miscarriage as relative contribution of variant genotype of MTHFR C677T is only twofold and further decreased to only onefold, and MTHFD-1958 lost its significance upon meta-analysis.
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20
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Cao Y, Xu J, Zhang Z, Huang X, Zhang A, Wang J, Zheng Q, Fu L, Du J. Association study between methylenetetrahydrofolate reductase polymorphisms and unexplained recurrent pregnancy loss: a meta-analysis. Gene 2012. [PMID: 23201418 DOI: 10.1016/j.gene.2012.10.091] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recurrent pregnancy loss is an important clinical problem. Recently, high-level homocysteine in blood has been considered as a possible cause. Genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR) have been proved to be the common hereditary factors of high-level homocysteine. The association between MTHFR polymorphisms and unexplained recurrent pregnancy loss (URPL) has been reported but with controversial results. The purpose of present study is to collect and analyze published available data, and evaluate the association between MTHFR polymorphisms and URPL. METHODS A meta-analysis was performed to examine the association between MTHFR polymorphisms (C677T and A1298C) and URPL. Odds ratio (OR) and its 95% confidence interval (CI) were used in each study of genotype and allele contrast. RESULT(S) MTHFR C677T: The analysis included 3559 URPL cases and 5097 healthy controls. Overall random-effects odds ratios (ORs) were 1.68 (95% CI, 1.32-2.13; P<0.0001) for TT versus total genotypes, 1.35 (95% CI, 1.04-1.76; P=0.0224) for TT and CT genotype combined versus total genotypes and 1.34 (95%CI, 1.13-1.58; P<0.0001) for T versus total alleles. Although significant heterogeneity was found in C677T, it became weaker in the East Asian subgroup and the mixed subgroup when separated by ethnic subgroups. The results showed significant association between MTHFR C677T and URPL in the East Asian subgroup (ORs 2.11 for TT versus total genotype (P=0.0004) and 1.53 for T versus total alleles (P<0.0001)) and in the mixed subgroup (ORs 3.47 for TT versus total genotypes (P<0.0001) and 1.80 for T versus total alleles (P<0.027)), but not in Caucasian subgroup. MTHFR A1298C: The study involved 1163 URPL cases and 1061 healthy controls. Overall random-effects odds ratios (ORs) were 1.37 (95% CI, 0.71-2.67; P=0.3456) for CC versus total genotypes, 1.16 (95%CI, 0.98-1.38; P=0.0833) for CC+AC versus total genotypes and 1.04 (95%CI, 0.84-1.29; P=0.7112) for C versus total alleles. No significant association between MTHFR A1298C polymorphism and URPL was found. CONCLUSIONS These results indicate a significant association between MTHFR C677T mutation and URPL in the East Asian subgroup and mixed subgroup, but no significance in MTHFR A1298C mutation.
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Affiliation(s)
- Yunlei Cao
- Fudan university, 130 Dong'an Road, Shanghai 200032, China
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21
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Wu X, Zhao L, Zhu H, He D, Tang W, Luo Y. Association Between theMTHFRC677T Polymorphism and Recurrent Pregnancy Loss: A Meta-Analysis. Genet Test Mol Biomarkers 2012; 16:806-11. [DOI: 10.1089/gtmb.2011.0318] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xiaoming Wu
- Lab of Molecular Genetics of Aging and Tumor, Faculty of Life Science and Technology and Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Lanjun Zhao
- Lab of Molecular Genetics of Aging and Tumor, Faculty of Life Science and Technology and Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Hui Zhu
- Lab of Molecular Genetics of Aging and Tumor, Faculty of Life Science and Technology and Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Dajian He
- Lab of Molecular Genetics of Aging and Tumor, Faculty of Life Science and Technology and Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Wenru Tang
- Lab of Molecular Genetics of Aging and Tumor, Faculty of Life Science and Technology and Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China
- State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Ying Luo
- Lab of Molecular Genetics of Aging and Tumor, Faculty of Life Science and Technology and Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China
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