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Violette CJ, Aberle LS, Anderson ZS, Komatsu EJ, Song BB, Mandelbaum RS, Matsuzaki S, Ouzounian JG, Matsuo K. Pregnancy with endometriosis: Assessment of national-level trends, characteristics, and maternal morbidity at delivery. Eur J Obstet Gynecol Reprod Biol 2024; 299:1-11. [PMID: 38815411 DOI: 10.1016/j.ejogrb.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To examine pregnancy characteristics and maternal morbidity at delivery among pregnant patients with a diagnosis of endometriosis. STUDY DESIGN This cross-sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. Study population was 17,796,365 hospital deliveries from 2016 to 2020, excluded adenomyosis and uterine myoma. The exposure was endometriosis diagnosis. Main outcome measures were clinical and pregnancy characteristics and severe maternal morbidity at delivery related to endometriosis, assessed with multivariable regression model. RESULTS Endometriosis was diagnosed in 17,590 patients. The prevalence of endometriosis increased by 24 % from one in 1,191 patients in 2016 to one in 853 patients in 2020 (adjusted-odds ratio [aOR] 1.24, 95% confidence interval [CI] 1.19-1.30). Clinical and pregnancy characteristics that had greater than two-fold association to endometriosis included polycystic ovary syndrome, placenta previa, cesarean delivery, maternal age of ≥30 years, prior pregnancy loss, and anxiety disorder. Pregnant patients with endometriosis were more likely to have the diagnosis of measured severe maternal morbidity during the index hospitalization for delivery (47.8 vs 17.3 per 1,000 deliveries, aOR 1.91, 95%CI 1.78-2.06); these associations were more prominent following vaginal (aOR 2.82, 95%CI 2.41-3.30) compared to cesarean (aOR 1.85, 95%CI 1.71-2.00) deliveries. Among the individual morbidity indicators, endometriosis was most strongly associated with thromboembolism (aOR 5.05, 95%CI 3.70-6.91), followed by sepsis (aOR 2.39, 95%CI 1.85-3.09) and hysterectomy (aOR 2.18, 95%CI 1.85-2.56). When stratified for endometriosis anatomical site, odds of thromboembolism was increased in endometriosis at distant site (aOR 9.10, 95%CI 3.76-22.02) and adnexa (aOR 7.37, 95%CI 4.43-12.28); odds of sepsis was most increased in endometriosis at multi-classifier locations (aOR 7.33, 95%CI 2.93-18.31) followed by pelvic peritoneum (aOR 5.54, 95%CI 2.95-10.40); and odds of hysterectomy exceeded three-fold in endometriosis at adnexa (aOR 3.00, 95%CI 2.30-3.90), distant site (aOR 5.36, 95%CI 3.48-8.24), and multi-classifier location (aOR 4.46, 95%CI 2.11-9.41). CONCLUSION The results of this nationwide analysis suggest that pregnancy with endometriosis is uncommon but gradually increasing over time in the United States. The data also suggest that endometriosis during pregnancy is associated with increased risk of severe maternal morbidity at delivery, especially for thromboembolism, sepsis, and hysterectomy. These morbidity risks differed by the anatomical location of endometriosis.
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Affiliation(s)
- Caroline J Violette
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Laurel S Aberle
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Zachary S Anderson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Emi J Komatsu
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Bonnie B Song
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Rachel S Mandelbaum
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Shinya Matsuzaki
- Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan
| | - Joseph G Ouzounian
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
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Wang L, Ran L, Tian Y, Jin Y, Yi J, He X. Effect of thrombomodulin gene polymorphisms on venous thromboembolism: An analysis of evidence involving 6,629 patients. Vascular 2024; 32:374-384. [PMID: 36278273 DOI: 10.1177/17085381221135698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
BACKGROUD The association between thrombomodulin gene (THBD) c.1418 C>T polymorphisms and the risk of venous thromboembolism (VTE) is controversial. The purpose of this meta-analysis was to evaluate THBD c.1418 C>T polymorphisms and the risk of VTE. METHODS Computer searches were performed on the CNKI, Wanfang database, VIP database, PubMed, Embase, Web of Science, and Cochrane Library databases. The retrieval time limit was from the establishment of the database to June 2022. Case-control studies and cohort studies of THBD c.1418 C>T polymorphisms associated with VTE were included. The literature was screened according to inclusion and exclusion criteria, data extraction and literature quality evaluation. Meta-analysis was performed using STATA 14.0 software. RESULTS A total of 12 literature were included, including 2980 cases in the case group and 3649 cases in the control group. The meta-analysis results showed no significant association of the THBD c.1418 C> T polymorphisms with the occurrence of VTE (T vs C: OR = 1.17, 95%CI = 0.93-1.48; TT vs CT+CC: OR = 1.00, 95%CI = 0.75-1.33; TT+CT vs CC: OR = 1.22, 95%CI = 0.94-1.59). Subgroup analyses revealed an increased risk of VTE in Asian populations due to THBD c.1418 C>T polymorphisms (T vs C: OR = 1.48, 95%CI = 1.06-2.07; TT vs CT+CC: OR = 1.80, 95%CI = 1.13-2.85; TT+CT vs CC: OR = 1.58, 95%CI = 1.07-2.32). THBD c.1418 C>T polymorphisms increased the risk of DVT (T vs C: OR = 1.51, 95%CI = 1.24-1.85; TT vs CT+CC: OR = 1.85, 95%CI = 1.10-3.12; TT+CT vs CC: OR = 1.64, 95%CI = 1.28-2.11). THBD c.1418 C>T polymorphisms reduced the risk of VTE in non-Asian populations (TT vs CT+CC: OR = 0.66, 95%CI = 0.45-0.98). CONCLUSION THBD c.1418 C>T polymorphisms is associated with VTE in Asian population, which may be a factor in the occurrence of VTE in Asian population. THBD c.1418 C>T polymorphisms increases the risk of DVT. Given the limitations of this meta-analysis, the conclusions require being further supported by large-scale and high-quality studies.
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Affiliation(s)
- Lang Wang
- Nursing Department, Zhuzhou Central Hospital, Zhuzhou, China
| | - Luqin Ran
- Department of Oncology, Chongqing General Hospital, Chomgqing, China
| | - Yanzhen Tian
- Nursing Department, Zhuzhou Central Hospital, Zhuzhou, China
| | - Yunrui Jin
- Department of Oncology, Chongqing General Hospital, Chomgqing, China
| | - Jinhua Yi
- Operating Theater, Zhuzhou Central Hospital, Zhuzhou, China
| | - Xiaoyuan He
- Nursing Department, Zhuzhou Central Hospital, Zhuzhou, China
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Solela G, Aschenek A, Amsalu C. Recurrent deep vein thrombosis in a young patient of African descent: challenging the prevailing stance on the significance of MTHFR C677T mutation. Oxf Med Case Reports 2023; 2023:omad132. [PMID: 38145269 PMCID: PMC10735354 DOI: 10.1093/omcr/omad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/15/2023] [Accepted: 10/17/2023] [Indexed: 12/26/2023] Open
Abstract
Background Although numerous gene variations, such as those in the methylenetetrahydrofolate reductase (MTHFR) gene, have been implicated in an increased risk of venous thrombosis, current recommendations do not advocate genetic testing if there is no clinically meaningful association with thrombosis. Case Presentation A 30-year-old male patient presented with left lower limb swelling of two days with prior history of deep vein thrombosis and superficial thrombophlebitis. His left lower limb was grossly swollen. Doppler study showed thrombosis of left common femoral, superficial femoral and iliac veins and work up for inherited thrombophilia was negative except detection of MTHFR C677T mutation. Conclusion In spite of the great controversy regarding the strong association between MTHFR C677T mutation and venous thromboembolism, it is worth considering genetic testing as part of work-up for inherited thrombophilia in young patients, particularly of African descent, if they have recurrent deep vein thrombosis with no obvious risk factors.
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Affiliation(s)
- Gashaw Solela
- Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Addis Aschenek
- Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Chali Amsalu
- College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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4
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Zhang W, Chen L, Cao G, Wang F, Chen E. Relationship between MTHFR gene polymorphism and risk of thrombosis in postoperative patients with colorectal cancer. Exp Ther Med 2023; 26:588. [PMID: 38023362 PMCID: PMC10665995 DOI: 10.3892/etm.2023.12287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 04/26/2023] [Indexed: 12/01/2023] Open
Abstract
An association between the methylenetetrahydrofolate reductase (MTHFR) C667T genotype and the risk of colorectal cancer, as well as a link between MTHFR gene polymorphism and thrombosis, have been revealed. However, the connection between MTHFR gene polymorphism and the risk of thrombosis in patients with colorectal cancer has remained to be fully elucidated. The present study investigated the link between MTHFR gene polymorphism and basic clinical data, postoperative D-dimer (DDi), postoperative thromboelastogram and postoperative thrombosis in 591 patients who underwent surgery for colorectal cancer. Postoperative DDi, thromboelastogram and postoperative thrombosis were not significantly different among patients with colorectal cancer and different MTHFR genotypes. While the results were 'negative', the present study may help physicians understand that it is not necessary to detect MTHFR polymorphism for therapeutic purposes. Regarding the danger of venous thrombosis, more focus should be placed on the standardized procedural enforcement system for deep vein thrombosis prevention for patients undergoing pelvic and abdominal surgery.
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Affiliation(s)
- Wei Zhang
- Department of Colorectal Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Li Chen
- Department of Colorectal Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Gaoyang Cao
- Department of Colorectal Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Fei Wang
- Department of Colorectal Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Engeng Chen
- Department of Colorectal Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
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Diakite B, Kassogue Y, Maiga M, Dolo G, Kassogue O, Holl JL, Joyce B, Wang J, Cisse K, Diarra F, Keita ML, Traore CB, Kamate B, Sissoko SB, Coulibaly B, Sissoko AS, Traore D, Sidibe FM, Bah S, Teguete I, Ly M, Nadifi S, Dehbi H, Kim K, Murphy R, Hou L. Lack of Association of C677T Methylenetetrahydrofolate Reductase Polymorphism with Breast Cancer Risk in Mali. Genet Res (Camb) 2023; 2023:4683831. [PMID: 36721432 PMCID: PMC9873441 DOI: 10.1155/2023/4683831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 12/22/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
Methylenetetrahydrofolate reductase (MTHFR) plays a major role in the metabolism of folates and homocysteine, which in turn can affect gene expression and ultimately promote the development of breast cancer. Thus, mutations in the MTHFR gene could influence homocysteine, methionine, and S-adenosylmethionine levels and, indirectly, nucleotide levels. Imbalance in methionine and S-adenosylmethionine synthesis affects protein synthesis and methylation. These changes, which affect gene expression, may ultimately promote the development of breast cancer. We therefore hypothesized that such mutations could also play an important role in the occurrence and pathogenesis of breast cancer in a Malian population. In this study, we used the PCR-RFLP technique to identify the different genotypic profiles of the C677T MTHFR polymorphism in 127 breast cancer women and 160 healthy controls. The genotypic distribution of the C677T polymorphism in breast cancer cases was 88.2% for CC, 11.0% for CT, and 0.8% for TT. Healthy controls showed a similar distribution with 90.6% for CC, 8.8% for CT, and 0.6% for TT. We found no statistical association between the C677T polymorphism and breast cancer risk for the codominant models CT and TT (p > 0.05). The same trend was observed when the analysis was extended to other genetic models, including dominant (p = 0.50), recessive (p = 0.87), and additive (p = 0.50) models. The C677T polymorphism of MTHFR gene did not influence the risk of breast cancer in the Malian samples.
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Affiliation(s)
- Brehima Diakite
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Yaya Kassogue
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Mamoudou Maiga
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
- Preventive Medicine Department, Northwestern University, Chicago, IL 60611, USA
| | - Guimogo Dolo
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Oumar Kassogue
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Jane L Holl
- Department of Neurology, University of Chicago, Chicago, IL 60637, USA
| | - Brian Joyce
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
- Preventive Medicine Department, Northwestern University, Chicago, IL 60611, USA
| | - Jun Wang
- Preventive Medicine Department, Northwestern University, Chicago, IL 60611, USA
- Department of Neurology, University of Chicago, Chicago, IL 60637, USA
| | - Kadidiatou Cisse
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Fousseyni Diarra
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Mamadou L Keita
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Cheick B Traore
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bakarou Kamate
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Sidi B Sissoko
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bourama Coulibaly
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Adama S Sissoko
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Drissa Traore
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Fatoumata M Sidibe
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Sekou Bah
- Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Ibrahim Teguete
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Madani Ly
- Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | | | - Hind Dehbi
- Hassan II University Aïn Chock, Casablanca, Morocco
| | - Kyeezu Kim
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
- Preventive Medicine Department, Northwestern University, Chicago, IL 60611, USA
| | - Robert Murphy
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Lifang Hou
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
- Preventive Medicine Department, Northwestern University, Chicago, IL 60611, USA
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Lee S, Lee CH, Seo MS, Yoo JI. Integrative analyses of genes about venous thromboembolism: An umbrella review of systematic reviews and meta-analyses. Medicine (Baltimore) 2022; 101:e31162. [PMID: 36316870 PMCID: PMC9622592 DOI: 10.1097/md.0000000000031162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, many studies have found possible links between gene polymorphisms and venous thromboembolism (VTE). By identifying genetic risk factors before facing environmental risk factors such as surgical interventions and COVID-19 vaccination, we could rapidly respond to the risk of VTE. The aim of this study was to perform an umbrella review of genetic variants related to VTE. Integrative gene analysis of VTE was performed to identify critical genetic variations. METHODS This study conducted an umbrella review of systematic reviews and meta-analyses. All included studies were selected from the PubMed/MEDLINE database. To select eligible studies, the following variables were extracted: first author name; effect size of each study genetic variant; year of publication; the number of studies included in each article; ethnicity, sample size, P values, and heterogeneity estimates. To assess cumulative evidence in genetic epidemiology about effects of gene polymorphisms on VTE, Human Genome Epidemiology Network's Venice criteria were used. Methodological quality assessment was conducted with JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. RESULTS Genes provided in the present study with genetic variants associated with VTE were FVL (G1691A), Prothrombin (G20210A), MTHFR (C677T, A1298C), PAI-1 (4G/5G), factor VII activating protease (1601G > A), and endothelial protein C receptor (g.6936A_G, c.4600A_G). Among them, variants in FVL, Prothrombin, MTHFR, and PAI-1 showed high significance. Particularly, variants in Prothrombin (G20210A), MTHFR (C677T), and PAI-1 (4G/5G) had more than 2 types of model significance. CONCLUSION The present study performed a systematic review of genetic variants associated with VTE. Our results could lead to a more comprehensive understanding of VTE etiology. These results could give a strategy of prediagnosis about evaluating individual risks of VTE who might be exposed to environmental risk factors.
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Affiliation(s)
- Sangyeob Lee
- Department of Biomedical Research Institute, Gyeongsang national university hospital, Jinju, South Korea
- Department of Theriogenology and Biotechnology, College of Veterinary Medicine, Gyeongsang National University, Jinju, South Korea
| | - Chang Han Lee
- Department of Rehabilitation Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Min Seok Seo
- Department of Orthopaedic Surgery, Gyeongsang national university hospital, Jinju, South Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang national university hospital, Jinju, South Korea
- * Correspondence: Jun-Il Yoo, Department of Orthopaedic Surgery, Gyeongsang National University Hospital, 90 Chilamdong, Jinju, Gyeongnamdo 660-702, Republic of Korea (e-mail: )
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7
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Wang B, Xu P, Shu Q, Yan S, Xu H. Combined Effect of MTHFR C677T and PAI-1 4G/5G Polymorphisms on the Risk of Venous Thromboembolism in Chinese Lung Cancer Patients. Clin Appl Thromb Hemost 2021; 27:10760296211031291. [PMID: 34325549 PMCID: PMC8327007 DOI: 10.1177/10760296211031291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Venous thromboembolism (VTE) is a common and potentially fatal complication in
cancer patients. Although several genetic risk factors related to thrombophilia
have been identified, their contributions for the occurrence of VTE in cancer
patients have conflicting results. The aim of this study was to evaluated the
gene polymorphisms of methylenetetrahydrofolate reductase (MTHFR) C677T and
plasminogen activator inhibitor-1 (PAI-1) 4G/5G in lung cancer patients, with
and without VTE, and the combined effect on the risk of VTE. 92 lung cancer
patients diagnosed with VTE (VTE group) and 122 lung cancer patients without VTE
(non-VTE group) were enrolled in the study. The gene polymorphisms were analyzed
by the method of polymerase chain reaction-restriction fragment length
polymorphism. Gene mutation of factor V Leiden was not detected both in non-VTE
group and VTE group. The frequency of MTHFR C677T homozygous mutation in VTE
group was 25.00%, higher than that in the non-VTE group without statistical
difference. It was found that the PAI-1 4G4G genotype is associated with a
higher risk of VTE (OR: 2.62, 95%CI: 1.19-5.75). Interestingly, the interaction
between MTHFR C677T and PAI-1 4G/5G polymorphisms showed that the coexistence of
the 2 homozygous mutation could further increase the risk of VTE. In conclusion,
PAI-1 4G/5G polymorphism may be an increased risk factor for VTE among lung
cancer patients in Chinese population. The homozygous MTHFR C677T mutation may
be not a risk factor for VTE but increases the risk, accompanied with PAI-1 4G5G
genotype.
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Affiliation(s)
- Baoyan Wang
- Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Peijuan Xu
- Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Qing Shu
- Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Simin Yan
- Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Hang Xu
- Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
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Gao M, Feng N, Zhang M, Ti X, Zuo X. Meta-analysis of the relationship between methylenetetrahydrofolate reductase C677T and A1298C polymorphism and venous thromboembolism in the Caucasian and Asian. Biosci Rep 2020; 40:BSR20200860. [PMID: 32614041 PMCID: PMC7352045 DOI: 10.1042/bsr20200860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/19/2020] [Accepted: 06/18/2020] [Indexed: 11/23/2022] Open
Abstract
Recent years, it is a highly debated topic that whether methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and A1298C polymorphism could increase susceptibility to venous thromboembolism (VTE) in the Asian and Caucasian. Therefore, we expect to settle that controversy evidentially. Basic methods: Electronic databases (Pubmed, embase, Cochrane library, scopus, OvidSP, Wiley Online library, Springer link, EBSCO, Elsevier Science Direct, Google scholar) without date limitation were searched. Crude odds ratio (OR) along with 95% confidence interval (95% CI) was calculated to assess the association quantitatively. Finally, a total of 37 eligible studies were included, containing 31 for MTHFR C677T polymorphism and 6 for MTHFR A1298C polymorphism. The pooled results suggested that MTHFR C677T mutation may increase susceptibility to VTE in reverse recessive model (CC+CT vs TT): OR = 0.68 (0.56, 0.83), reverse dominant model (CC vs CT +TT): OR = 0.82 (0.72, 0.94), heterozygote model (CT vs TT): OR = 0.65 (0.52, 0.81), homozygote model (CC vs TT): OR = 0.73 (0.60, 0.89) and allele model (C vs T): OR = 0.80 (0.71, 0.90). Subgroup analysis about Asian also support that results, but Caucasian group not. In addition, MTHFR A1298C polymorphism may be not related to VTE in all genetic model. The results of meta-analysis indicated that MTHFR C677T polymorphism might increase the risk of VTE, especially in Asian population.
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Affiliation(s)
- Miao Gao
- The First Affiliated Hospital of Air Force Medical University (XiJing Hospital), Respiratory and Critical Care Medicine, Xi’an, Shaanxi 710032, P.R. China
| | - Na Feng
- The First Affiliated Hospital of Air Force Medical University (XiJing Hospital), Respiratory and Critical Care Medicine, Xi’an, Shaanxi 710032, P.R. China
| | - Meixia Zhang
- School of Life Science and Technology, Xi'an Jiaotong University, No.28, Xianning West Road, Xi’an, Shaanxi 710049, P.R. China
- The First Affiliated Hospital of Air Force Medical University (XiJing Hospital), Department of Nursing, Xi’an, Shaanxi 710032, P.R.China
| | - Xinyu Ti
- The First Affiliated Hospital of Air Force Medical University (XiJing Hospital), Respiratory and Critical Care Medicine, Xi’an, Shaanxi 710032, P.R. China
| | - Xiuping Zuo
- The First Affiliated Hospital of Air Force Medical University (XiJing Hospital), Respiratory and Critical Care Medicine, Xi’an, Shaanxi 710032, P.R. China
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Habib E, Elshaer A, Shafquat A, Al-Ghamdi B. Pulmonary and Paradoxical Embolism after Slow Pathway Ablation: A Thrombotic Disorder Unmasked by a Rare Complication. J Atr Fibrillation 2019; 11:2142. [PMID: 31384363 DOI: 10.4022/jafib.2142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/14/2018] [Accepted: 12/26/2018] [Indexed: 11/10/2022]
Abstract
Cardiac electrophysiology study (EPS) and catheter ablation procedure are established diagnostic and therapeutic procedures for cardiac arrhythmias. Pulmonary embolism (PE) is a relatively rare but potentially fatal complication of Cardiac electrophysiology study (EPS). The paradoxical embolism (PDE) occurs due to an intracardiac defect with a right to left shunt with patent foramen ovale (PFO) being the most common cause. The simultaneous occurrence of PE and PDE is rare. Here we present a case of PE and PDE after EPS and radiofrequency catheter ablation (RFCA) of the slow pathway in a patient with recurrent supraventricular tachycardia (SVT) due to atrioventricular nodal reentry tachycardia (AVNRT). To our knowledge, such a case of PE and PDE has not been reported after SVT ablation.
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Affiliation(s)
- Eiad Habib
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC)
| | - Amani Elshaer
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC)
| | - Azam Shafquat
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC).,Alfaisal University, Riyadh, Saudi Arabia
| | - Bandar Al-Ghamdi
- Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC).,Alfaisal University, Riyadh, Saudi Arabia
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10
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Rai V. Association of methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with autism: evidence of genetic susceptibility. Metab Brain Dis 2016; 31:727-35. [PMID: 26956130 DOI: 10.1007/s11011-016-9815-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 02/23/2016] [Indexed: 01/18/2023]
Abstract
Autism (MIM 209850) is a heterogeneous neurodevelopmental disease that manifests within the first 3 years of life. Numerous articles reported that dysfunctional folate-methionine pathway enzymes may play an important role in the pathophysiology of autism. Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme of this pathway and MTHFR C677T polymorphism reported as risk factor for autism in several case control studies. However, controversial reports were also published. Hence the present meta-analysis was designed to investigate the relationship of the MTHFR C677T polymorphism with the risk of autism. Electronic databases were searched for case control studies with following search terms - 'MTHFR', 'C677T', in combination with 'Autism'. Pooled OR with its corresponding 95 % CI was calculated and used as association measure to investigate the association between MTHFR C677T polymorphism and risk of autism. Total of thirteen studies were found suitable for the inclusion in the present meta-analysis, which comprises 1978 cases and 7257 controls. Meta-analysis using all four genetic models showed significant association between C677T polymorphism and autism (ORTvs.C = 1.48; 95 % CI: 1.18-1.86; P = 0.0007; ORTT + CT vs. CC = 1.70, 95 % CI = 0.96-2.9, p = 0.05; ORTT vs. CC = 1.84, 95 % CI = 1.12-3.02, p = 0.02; ORCT vs.CC = 1.60, 95 % CI = 1.2-2.1, p = 0.003; ORTT vs.CT+CC = 1.5, 95 % CI = 1.02-2.2, p = 0.03). In total 13 studies, 9 studies were from Caucasian population and 4 studies were from Asian population. The association between C677T polymorphism and autism was significant in Caucasian (ORTvs.C = 1.43; 95 % CI = 1.1-1.87; p = 0.009) and Asian population (ORTvs.C = 1.68; 95 % CI = 1.02-2.77; p = 0.04) using allele contrast model. In conclusion, present meta-analysis strongly suggested a significant association of the MTHFR C677T polymorphism with autism.
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Affiliation(s)
- Vandana Rai
- VBS Purvanchal University, Jaunpur, 222003, UP, India.
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11
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Shadrina AS, Sevost'ianova KS, Shevela AI, Soldatsky EY, Seliverstov EI, Demekhova MY, Shonov OA, Ilyukhin EA, Smetanina MA, Voronina EN, Pikalov IV, Zolotukhin IA, Filipenko ML. Polymorphisms in the MTHFR and MTR genes and the risk of varicose veins in ethnical Russians. Biomarkers 2016; 21:619-24. [PMID: 27097558 DOI: 10.3109/1354750x.2016.1171902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The objective of this study was to study the association of polymorphisms MTHFR C677T (rs1801133) and MTR A2756G (rs1805087) with the risk of varicose veins in ethnical Russians. METHODS We genotyped 475 patients with varicose veins, 168 individual without chronic venous disease, and the population-based group of 896 subjects. Association was studied using logistic regression analysis adopting co-dominant, additive, recessive, and dominant models of inheritance. RESULTS None of the polymorphisms showed a statistically significant association with the risk of varicose veins. CONCLUSIONS Our results provide evidence that the studied polymorphisms do not contribute to genetic susceptibility to varicose veins in ethnical Russians.
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Affiliation(s)
- Alexandra Sergeevna Shadrina
- a Institute of Chemical Biology and Fundamental Medicine , Novosibirsk , Russia ;,b Novosibirsk State University , Novosibirsk , Russia
| | | | | | | | | | | | | | | | | | - Elena Nikolaevna Voronina
- a Institute of Chemical Biology and Fundamental Medicine , Novosibirsk , Russia ;,b Novosibirsk State University , Novosibirsk , Russia
| | | | | | - Maxim Leonidovich Filipenko
- a Institute of Chemical Biology and Fundamental Medicine , Novosibirsk , Russia ;,b Novosibirsk State University , Novosibirsk , Russia ;,f Kazan Federal University , Kazan , Republic of Tatarstan, Russia
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12
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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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13
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Dubský M, Jirkovská A, Pagáčová L, Bém R, Němcová A, Fejfarová V, Wosková V, Jude EB. Impact of Inherited Prothrombotic Disorders on the Long-Term Clinical Outcome of Percutaneous Transluminal Angioplasty in Patients with Diabetes. J Diabetes Res 2015; 2015:369758. [PMID: 26247037 PMCID: PMC4515498 DOI: 10.1155/2015/369758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/18/2015] [Accepted: 06/29/2015] [Indexed: 12/29/2022] Open
Abstract
The aim of our study was to analyse inherited thrombotic disorders that influence the long-term outcome of PTA. Methods. Diabetic patients with peripheral arterial disease (PAD) treated by PTA in our centre between 2008 and 2011 were included in the study. Patients were divided into unsuccessful PTA group (75 patients), successful PTA group (58 patients), and control group (65 patients, with diabetes but no PAD). Diagnosis of inherited thrombotic disorders included mutation in factor V (Leiden), factor II (prothrombin), and mutation in genes for methylenetetrahydrofolate reductase-MTHFR (C677T and A1298C). Results. The genotypic frequency of Leiden allele G1691A was significantly associated with a risk of unsuccessful PTA in comparison with successful PTA group and control group (OR 8.8 (1.1-70.6), p = 0.041, and OR 9.8 (1.2-79.2), p = 0.032, resp.). However, we only observed a trend for the association of the prothrombin allele G20210A and risk of PTA failure. The frequencies of alleles of MTHFR 677 or 1298 did not differ significantly among the groups. Conclusion. Our study showed higher frequency of heterozygous form of Leiden mutation in diabetic patients with unsuccessful outcome of PTA in comparison with patients with successful PTA and diabetic patients without PAD.
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Affiliation(s)
- Michal Dubský
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Alexandra Jirkovská
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Libuše Pagáčová
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Robert Bém
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Andrea Němcová
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Vladimíra Fejfarová
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Veronika Wosková
- Diabetes Centre, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic
| | - Edward B. Jude
- Diabetes Centre, Tameside Hospital NHS Foundation Trust and University of Manchester, Ashton-Under-Lyne OL6 9RW, UK
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Vesa ŞC, Trifa AP, Crişan S, Buzoianu AD. VKORC1 -1639 G>A Polymorphism in Romanian Patients With Deep Vein Thrombosis. Clin Appl Thromb Hemost 2015; 22:760-764. [PMID: 25976278 DOI: 10.1177/1076029615585993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
AIM The purpose of the research was to study the influence of several genetic factors, especially the -1693 G>A polymorphism of the VKORC1 gene, on the risk of acute unprovoked lower extremity deep vein thrombosis (DVT). MATERIALS AND METHODS The study included 127 patients (median age 63 [53.2; 72] years; 61 [48%] women and 66 [52%] men) who were diagnosed with acute lower extremity DVT and 114 controls (median age 62 [53; 73] years; 64 [56.1%] women and 50 [43.9%] men) without DVT. We recorded data regarding the history of DVT and the presence of varicose veins. We determined the genotypes for factor V Leiden (FVL) mutation, prothrombin G20210A mutation, VKORC1 -1639 G>A mutation, and PAI-1 -675 4G/5G polymorphism. RESULTS AND CONCLUSION Varicose veins were found in 67 (52.8%) patients and 29 (25.4%) controls (P < .001). FVL was present in 29 (22.8%) patients and 10 (8.8%) controls (P = .005). The VKORC1 (-1693 G>A) GG genotype was found in 42 (33.1%) patients and 41 (36%) controls, the GA genotype in 71 (55.9%) patients and 47 (41.2%) controls, and AA genotype in 14 (11%) patients and 26 (22.8%) controls (P = .020). Multivariate analysis showed that the presence of varicose veins, FVL, and VKORC1 -1639 G>A was independently associated with the risk of DVT. The VKORC1 (-1693 G>A) AA genotype was associated with fewer cases of DVT (odds ratio = 0.435; 95% confidence interval 0.205-0.991; P = .031).
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Affiliation(s)
- Ştefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Haţieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Adrian Pavel Trifa
- Department of Medical Genetics, "Iuliu Haţieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Sorin Crişan
- Fifth Department of Internal Medicine, Municipal Hospital of Cluj-Napoca, "Iuliu Haţieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Anca Dana Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Haţieganu" University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
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Superior vena cava syndrome and colon carcinoma: a report of a multifactorial association. Case Rep Oncol Med 2015; 2015:345804. [PMID: 25810936 PMCID: PMC4355600 DOI: 10.1155/2015/345804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/17/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction. Superior vena cava (SVC) syndrome results from the obstruction of blood flow through the SVC, having distinct pathophysiological underlying mechanisms. Cancer is associated with an increased risk of thromboembolism that varies according to patient-, tumor-, and treatment-related factors. An individualized clinical approach is important to pursue the accurate diagnosis of the underlying pathology causing thromboembolism in cancer patients. Case Presentation. The authors present a case of a 58-year-old male with an infrequent presentation of an unknown colon carcinoma, who has never had any symptom until he was hospitalized with the diagnosis of superior vena cava syndrome and pulmonary thromboembolism. The patient had an advanced disease by the time of diagnosis and molecular alterations contributing to abnormal hemostasis. He presented venous and arterial thromboembolism and developed disseminated intravascular coagulopathy after surgery, anticoagulant and transfusion therapy, dying 40 days after the hospitalization. Conclusion. The authors discuss thromboembolic disease and tumor metastasis roles in a cancer patient with SVC syndrome. Thromboembolism in a malignancy context is a challenging clinical entity. A multifactorial perspective of the thrombotic disease is warranted to approach thromboembolism risk and stratify patients suitable to receive adequate anticoagulant prophylaxis and targeted therapies, aiming to improve clinical prognosis.
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