还原叶酸载体1基因A80G多态性与非综合征型唇腭裂的相关性研究

目的探讨还原叶酸载体(RFC)1基因A80G多态性与非综合症型唇腭裂(NSCL/P)相关性。方法收集97个核心家庭和104个对照家庭,用聚合酶链式反应-限制性片段长度多态性方法,进行RFC1基因A80G位点多态性检测,用人群关联研究分析、NSCL/P核心家庭的TDT、HHRR、FBAT等检验统计分析。结果人群关联研究分析,子代、父亲、母亲病例组和对照组之间基因型和等位基因的分布差异无显著性(P>0.05)。AG基因型相对于AA基因型的比值比OR(95%CI)、P值分别为子代0.87(0.44～1.70)、0.657;父亲1.09(0.54～2.21)、0.788;母亲1.63(0.79～3.36)、0.152。GG基因型相对于AA基因型的OR(95%CI)、P值分别为子代0.48(0.19～1.23)、0.094;父亲0.93(0.38～2.23)、0.850;母亲1.30(0.46～3.67)、0.584。G基因相对于A基因的OR(95%CI)、P值分别为子代1.22(0.78～1.94)、0.386;父亲1.02(0.64～1.61)、0.945;母亲0.91(0.58～1.41)、0.660。携带有突变基因G并不能增加患NSCL/P的危险。NSCL/P核心家庭分析,TDT检验中传递G等位基因给患病子代的为40次,传递A等位基因的为71次,等位基因A比突变等位基因G更易传递给患病子代(χ2=8.658,P<0.05;HHRR检验χ2=10.31,P<0.05;FBAT检验Z=2.942,P<0.05)。结论利用核心家庭资料进行统计分析的结果则认为RFC1基因A80G位点变异存在传递不平衡现象,这与NSCL/P发病危险之间存在有一定的关联关系,等位基因A可能与NSCL/P的高危显性有关系。     

神经管畸形儿及其父母还原叶酸载体基因多态性的 FBAT关联研究

目的：探讨神经管畸形（neural tube defects, NTDs）儿及其父母的还原叶酸载体基因（reduced folate carrier gene, RFC1）A80G多态性在NTDs发生危险中的作用,为探讨NTDs遗传易感标记物提供流行病学依据。方法：应用聚合酶链反应-限制性片段长度多态性（PCR?鄄RFLP）技术,检测104例NTDs儿及其父母和100例健康对照儿及其父母的RFC1 A80G多态性,利用病例-父母对照研究中传递/不平衡检验（TDT检验）和以家系为基础的关联检验（FBAT检验）分析NTDs儿的父母RFC1基因A80G多态性与NTDs发生危险的关联,及其在子代中传递的作用强度。结果：患儿父母均为杂合子GA/GA的比例高达36.36%,NTDs患儿成为纯合子GG的概率为25%时具有统计学意义（P＜0.05）,表明患儿接受父母遗传的G等位基因的概率均为25%,并有发生NTDs危险的可能。NTDs的TDT检验结果显示,患儿父母传递等位基因G的危险性是传递等位基因A危险性的1.56 倍（95%CI：1.07~2.28）,认为该基因在亲代和NTDs子代间存在传递失衡现象。FBAT检验中,不论显性模型还是隐性模型,均未发现等位基因G与NTDs的发生危险存在关联,该结果与上述病例-父母对照研究TDT检验结果不一致。结论：虽然TDT检验中G等位基因与NTDs发生危险有关,但FBAT检验未发现G等位基因与NTDs发生危险存在关联,应进一步加大核心家系数量验证该结果。     

还原叶酸载体基因多态性与神经管畸形关联的父母-病例对照研究

目的对神经管畸形（NTDs）发病危险和还原叶酸载体基因（RFC1）A80G多态性进行关联研究，为寻找NTDs的遗传易感标志物提供流行病学依据。方法采用RFLP—PCR方法．对104例NTDs儿及其父母和99名正常儿童及其父母的外周血DNA进行RFC1第80位SNP检测，对核心家庭基因型进行病例对照研究，对NTDs杂合子父母G等位基因进行传递不平衡检验（TOT）。结果NTDs儿G等位基因频率高于对照儿，OR值为1．64（95％CI：1．08～2．49）；GG基因型的患儿发生NTDs危险高于AA基因型（OR=2．56，95％CI：1．04～6．36）；TDT结果显示，RFC1等位基因G与NTDs之间存在关联（x^2=5．2364，P〈0．05），携带G等位基因发生NTDs的危险是非携带者的1．56倍（95％CI：1．07～2．28）。结论发现在中国人群中RFC1基因多态性与NTDs存在关联，初步表明该基因G等位基因可能是NTDs发生的遗传易感基因之一。     

MTHFR基因、CBS基因、环境因素与先天性心脏病的病例对照研究

目的 探讨父母亚甲基四氢叶酸还原酶（MTHFR）基因C677T、胱硫醚β-合酶（CBS）基因T833C、环境因素与子代先天性心脏病（CHD）发生之间的关联。方法 采用1：1配对病例对照研究方法，分析115对CHD患儿与对照儿父母的环境暴露因素，并检测其MTHFR与CBS基因型，对CHD可能的危险因素进行单因素及多因素条件logistic回归分析。结果 母亲怀孕早期接触农药（OR=8．62）、妊娠合并症（OR=2．069）、孕早期感冒（OR=4．125）、孕期情绪状况（OR=4．653）、母亲MTHFR基因677TT型（OR=3．872）共5个因素为予代发生CHD的危险因素。结论 母亲MTHFR基因677TT型与子代CHD发生有关，未发现父母CBS基因T833C与子代CHD存在关联，母亲怀孕早期接触农药、妊娠合并症、孕早期感冒、孕期情绪紧张或忧郁可能增加子代发生CHD的危险。     

CYP450基因多态性及环境危险因素暴露与先天性心脏病关系病例对照研究

目的探讨子代CYP450基因多态性及母亲孕期环境危险因素暴露与先天性心脏病(CHD)发病的关系以及二者在CHD发生中是否存在交互作用。方法采用病例对照研究方法,将2011年10月-2013年1月在山东省济宁医学院第一附属医院确诊的160例0~7周岁单纯性CHD患儿和同期在该院进行体检或就诊的160例非心脏病幼儿分别作为病例组和对照组,采用访谈方式进行问卷调查,获得研究对象母亲孕期环境危险因素暴露信息,采集研究对象空腹静脉,血应用聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)检测CYP450基因多态性;应用单因素和多因素条件logistic回归模型分析子代CYP450基因多态性和母亲孕期环境危险因素暴露与CHD发病的关联强度,并采用相加模型交互作用指标评价二者的交互作用。结果多因素条件logistic回归分析结果显示,子代CYP1A1基因rs1048943位点纯合子突变型是CHD发病的保护因素(OR=0.369,95%CI=0.138~0.986);母亲孕前3个月使用染发剂(OR=5.621.95%CI=1.401~22.541)、孕前3个月被动吸烟(OR=2.511,95%CI=1.342~4.699)、孕早期被动吸烟(OR=2.441,95%CI=1.306~4.561)、孕早期居住在3年内装修过的居室(OR=4.159,95%CI=1.698~10.182)和孕早期服用解热镇痛药(OR=3.901,95%CI=1.271~11.971)是CHD发病的危险因素。交互作用分析结果显示,子代携带CYPIA1 rs1048943位点纯合子突变型有减弱环境因素致病风险的趋势,但交互作用指标无统计学意义。结论子代携带CYP1A1纯合子突变型对CHD发病有保护作用,母亲孕前及孕早期应尽量避免或减少环境危险因素的暴露,以预防子代CHD的发生。     

TGF-α基因多态性及叶酸与非综合征性唇腭裂关系

目的 研究山东汉族人转化生长因子-α(TGF-α)基因多态性及叶酸补充与非综合征性唇腭裂的关系.方法 通过问卷调查获得所有研究对象母亲孕前孕期叶酸补充等资料.应用多聚酶链反应(PCR)结合限制性酶切方法,确定199例非综合征性唇腭裂患者与203名正常人的基因型.将基因型与叶酸补充因素进行分析.结果 非综合征性唇腭裂患者TGF-α的C2等位基因频率明显高于正常对照组,差异有统计学意义(P<0.05);孕前孕期不补充叶酸的孕妇发生非综合征性唇腭裂增多,差异有统计学意义(P<0.05).C1C2基因型与叶酸缺乏因素有交互作用.结论 TGF-α基因的突变及孕期叶酸缺乏与汉族人非综合征性唇腭裂的发生有相关性.含有C2等位基因的个体对孕期叶酸缺乏的危险因素更为敏感.     

母亲胱硫醚β-合酶基因多态性与子代先心病及亚型的关联研究

目的 探讨母亲胱硫醚β-合成酶(cystathionineβsynthase, CBS)基因多态性与子代先心病(congenital heart disease, CHD)及其亚型的关联,为CHD遗传易感标志物的研究提供流行病学依据。方法 以464例单纯CHD患儿母亲为病例组,504例正常儿童母亲为对照组,开展病例对照研究。通过问卷调查,收集研究对象的基本信息。完成调查问卷后,采集5ml血液,用于CBS基因多态性的检测。利用多因素logistic回归模型评估CBS基因多态性与CHD及亚型的关联;利用Haploview 4.2软件的四配子法构建单倍型,评估单倍型与CHD的关联;利用广义多因子降维法(GMDR)分析基因-基因交互作用与CHD的关联。结果 多因素logistic回归分析结果显示,母亲CBS基因位点rs2851391和rs234714的多态性与子代CHD及其两种亚型(ASD和PDA)的发病存在关联;且经FDR调整后,关联仍然具有统计学意义(Q_FDR<0.05)。5个SNP位点均与VSD的发生无关(Q_FDR>0.05)。GM...     

母亲胱硫醚β-合酶基因多态性与子代先心病及亚型的关联研究北大核心CSCD

目的探讨母亲胱硫醚β-合成酶(cystathionineβsynthase,CBS)基因多态性与子代先心病(congenital heart disease,CHD)及其亚型的关联,为CHD遗传易感标志物的研究提供流行病学依据。方法以464例单纯CHD患儿母亲为病例组,504例正常儿童母亲为对照组,开展病例对照研究。通过问卷调查,收集研究对象的基本信息。完成调查问卷后,采集5ml血液,用于CBS基因多态性的检测。利用多因素logistic回归模型评估CBS基因多态性与CHD及亚型的关联;利用Haploview 4.2软件的四配子法构建单倍型,评估单倍型与CHD的关联;利用广义多因子降维法(GMDR)分析基因-基因交互作用与CHD的关联。结果多因素logistic回归分析结果显示,母亲CBS基因位点rs2851391和rs234714的多态性与子代CHD及其两种亚型(ASD和PDA)的发病存在关联;且经FDR调整后,关联仍然具有统计学意义(Q_(FDR)<0.05)。5个SNP位点均与VSD的发生无关(Q_(FDR)>0.05)。GMDR分析结果显示,5个SNP位点的基因-基因交互作用模型与子代CHD的发生无关(P>0.05)。rs1051319和rs2851391位点构成的单倍型G-T可能与子代CHD的发生有关(Q_(FDR)<0.05)。结论母亲CBS基因多态性与子代CHD、ASD和PDA的发生有关,CBS基因位点构成的单倍型(G-T)也与子代CHD的发生有关。     

eNOS基因T-786C和G894T单核苷酸多态性与冠心病关系的病例对照研究

目的探讨e NOS基因T-786C和G894T两个多态性位点与冠心病(CHD)的相关性。方法以842例CHD确诊患者为病例组,选择同期842名经年龄与性别相匹配的未患有CHD的健康人群为对照,采用Taqman-PCR技术检测两组e NOS基因T-786C和G894T位点基因型,并分析其与CHD的相关性。结果对照组T-786C和G894T位点基因型频率分布符合Hardy-Weinberg遗传平衡定律;病例组与对照组比较,T-786C位点C等位基因(8.79%vs 6.53%,校正OR=2.54,95%CI:2.01~3.14,P=0.01)、CC基因型(0.84%vs0.11%,校正OR=3.81,95%CI:1.74~5.56,P=0.04)和TC/CC基因型(16.75%vs 13.06%,校正OR=2.11,95%CI:1.75~2.98,P=0.03)的频率分布差异均有统计学意义;而TC基因型在两组中的频率分布差异无统计学意义(P0.05)。病例组中G894T位点T等位基因、GT基因型、TT基因型和GT/TT基因型的频率与对照组比较,差异均无统计学意义(P0.05)。结论 e NOS基因T-786C位点的C等位基因、CC基因型和TC/CC基因型与CHD患病存在统计学关联,提示该位点可能参与CHD的发病过程,C等位基因和CC基因型、TC/CC基因型可能是CHD发病风险易感因子。     

孕期环境暴露因素与先天性心脏病关系

目的 探讨母亲孕期环境暴露因素与子代先天性心脏病(CHD)之间的关系,为CHD的干预防治提供科学依据.方法 采用1∶1配对病例对照研究,分析115对CHD患儿与对照组父母的环境暴露因素,对CHD可能的危险因素进行单因素及多因素条件Logistic回归分析.结果 母亲怀孕早期接触农药(OR=7.316,95%CI=1.196～44.731)、孕早期感冒(OR=4.806,95%CI=2.092～11.04)、妊娠合并症(OR:2.851,95%CI=1.189～6.838)、孕期情绪状况(OR=3.318,95%CI=1.829～6.018)4个因素为子代发生CHD的危险因素.结论 母亲怀孕早期接触农药、孕早期感冒、孕期患妊娠合并症、孕期情绪紧张或忧郁可能增加子代发生CHD的危险.     

Genetic variation of infant reduced folate carrier (A80G) and risk of orofacial defects and congenital heart defects in China

PURPOSE: This study was designed to investigate whether the risks of congenital heart defects (CHD) and orofacial defects were influenced by a polymorphism of the offspring's RFC1 or by an interaction between the RFC1 gene and maternal periconceptional use of folic acid. METHODS: A case-control study was conducted. A total of 82 families with a child affected by cleft lip with or without cleft palate (CLP), 67 families with a child-affected by CHD, and 100 nonmalformed control families were genotyped using PCR-RFLP. RFC1 G allele was tested through family-based association test. RESULTS: Among mothers who did not use folic acid, the risks of 4.03 (95% CI = 1.33-12.77) for the G80/G80 genotype and 4.14 (95% CI = 1.06-16.82) for the G80/A80 genotype were observed relative to the A80/A80 genotype for CHD offspring. In family-based association tests (FBAT), offspring carrying the G allele for RFC1 is at increased risk for CHD (Z = 2.140, p < .05). No significant association was found between either RFC1 genotype or maternal folic acid supplementation and the risks of CLP. CONCLUSIONS: Our findings suggest that the RFC1 G allele is likely to be an important candidate gene in folate transport and to be associated with risk for CHD. This study found modest evidence for a gene-nutrient interaction between offspring RFC1 genotype and periconceptional intake of folic acid on the risk of congenital heart defects.     

Periconceptional folate intake by supplement and food reduces the risk of nonsyndromic cleft lip with or without cleft palate

BACKGROUND: Inadequate maternal vitamin intake during pregnancy has been suggested as a risk factor for cleft lip with or without cleft palate (CLP). The independent role of folate has not been clarified. METHODS: To investigate the association between maternal folate intake by supplement and food and the risk of CLP offspring, a case-control study was conducted in the Netherlands (1998-2000) among 174 mothers of a child with nonsyndromic CLP and 203 mothers of a child without congenital malformations. RESULTS: Daily use of a folic acid supplement by mothers starting from 4 weeks before until 8 weeks after conception gave a 47% CLP risk reduction compared to mothers who did not use these supplements [odds ratio (OR): 0.53, 95% confidence interval (CI): 0.33, 0.85]. Ninety-three percent of the users took a supplement containing folic acid only. Dietary folate intake reduced CLP risk independently in a dose-response manner. The largest risk reductions were found on those mothers who had a diet of more than 200 microg folate per day in combination with a folic acid supplement (OR: 0.26, 95% CI: 0.09, 0.72). CONCLUSIONS: We demonstrated that periconceptional maternal folic acid supplement use was beneficial to reduce the risk for CLP. An additional effect of food folate was shown.     

Genetic variation of infant reduced folate carrier (A80G) and risk of orofacial and conotruncal heart defects

How folate reduces the risks of congenital anomalies is unknown. The authors focused on a gene involved in folate transport-reduced folate carrier-1 gene (RFC1). Using data from a California case-control study (1987-1989 births), the authors investigated whether the risks of orofacial clefts or conotruncal heart defects were influenced by a polymorphism of infant RFC1 or by an interaction between the RFC1 gene and maternal periconceptional use of vitamins containing folic acid. A total of 305 liveborn infants with cleft lip with or without cleft palate, 123 with cleft palate, 163 with conotruncal heart defects, and 364 nonmalformed controls were genotyped. Odds ratios of 1.6 (95% confidence interval: 0.9, 2.8) for the G80/G80 genotype and of 2.3 (95% confidence interval: 1.3, 3.9) for the G80/A80 genotype were observed relative to the A80/A80 genotype for conotruncal defects. Among mothers who did not use vitamins, the risk of conotruncal defects was 2.1 (95% confidence interval: 0.7, 5.9) for infants with genotype G80/G80 compared with those with the A80/A80 genotype. Among mothers who did use vitamins, the risk was 1.3 (95% confidence interval: 0.7, 2.7). Substantially elevated risks for either cleft group were not observed irrespective of genotype and use/nonuse of vitamins. Thus, this study found modest evidence for a gene-nutrient interaction between infant RFC1 genotype and periconceptional intake of vitamins on the risk of conotruncal defects.     

转化生长因子α基因多态性与唇腭裂关联的研究

目的 探讨中国部分地区人群非综合征型唇裂伴或不伴腭裂（nsCL/P）与转化生长因子α基因（TGFα）TaqI位点多态性之间的关系。方法 采用聚合酶链反应限制片段长度多态性分析方法，对149个nsCL／P核心家庭成员DNA标本进行TGFα Taq I突变位点的基因型检测。利用传递失衡检验和以家庭为基础的关联研究（FBAT）方法，分析TGFα Taq I突变与nsCL／P发生之间的关系。结果 未发现TGFα Taq I突变的致病晓等位基因在nsCL／P核心家庭成员中存在传递不平衡（P〉0．05）；采用FBAT分析，未发现C2等位基因及C2C1基因型与nsCL／P发病危险之间关联有统计学意义（P〉0．05）。结论 TGFα Taq I突变可能不是中国部分地区人群nsCL／P发生的易感基因。     

Maternal nutrient intakes and risk of orofacial clefts

BACKGROUND: Information about nutritional factors as potential risks of orofacial clefts is limited. METHODS: In this population-based case-control study, we investigated whether periconceptional intakes of supplemental folic acid, dietary folate, and several other nutrients were associated with orofacial clefts. We included data on deliveries from 1997 through 2000 in the National Birth Defects Prevention Study. Orofacial cleft cases were infants or fetuses born with cleft palate (CP) or with cleft lip with or without cleft palate (CLP). Infants without malformations were eligible as controls. Interview participation was 71% among case mothers and 68% among control mothers. Interviews were completed for 704 CLP cases, 404 CP cases, and 2594 controls. RESULTS: The odds ratio (OR) for CLP associated with use of vitamin supplements containing folic acid was 0.88 (95% confidence interval = 0.73-1.07) and for CP was 1.09 (0.84-1.40). Adjusting for maternal race/ethnicity, age, and education produced an OR of 1.01 (0.82-1.24) for CLP and 1.02 (0.77-1.34) for CP. We found some evidence for decreased CLP risks (>or=30% reduction in risk) with increasing intakes of total protein, choline, and methionine. Decreased CP risk was associated with increased intake of cysteine. Intakes of only 2 micronutrients, iron and riboflavin, were found to reduce CLP risk when adjusted for other nutrients. CONCLUSION: Our observations contribute to the limited body of evidence suggesting a woman's periconceptional diet may influence clefting risks in her offspring. Our finding of no reduction in clefting risk with periconceptional use of supplements containing folic acid is inconsistent with many previous observations but not all.     

Oral facial clefts and gene polymorphisms in metabolism of folate/one‐carbon and vitamin A: a pathway‐wide association study

An increased risk of facial clefts has been observed among mothers with lower intake of folic acid or vitamin A around conception. We hypothesized that the risk of clefts may be further moderated by genes involved in metabolizing folate or vitamin A. We included 425 case‐parent triads in which the child had either cleft lip with or without cleft palate (CL/P) or cleft palate only (CPO), and no other major defects. We analyzed 108 SNPs and one insertion in 29 genes involved in folate/one‐carbon metabolism and 68 SNPs from 16 genes involved in vitamin A metabolism. Using the Triad Multi‐Marker (TRIMM) approach we performed SNP, gene, chromosomal region, and pathway‐wide association tests of child or maternal genetic effects for both CL/P and CPO. We stratified these analyses on maternal intake of folic acid or vitamin A during the periconceptional period. As expected with this high number of statistical tests, there were many associations with P‐values<0.05; although there were fewer than predicted by chance alone. The strongest association in our data (between fetal FOLH1 and CPO, P=0.0008) is not in agreement with epidemiologic evidence that folic acid reduces the risk of CL/P in these data, not CPO. Despite strong evidence for genetic causes of oral facial clefts and the protective effects of maternal vitamins, we found no convincing indication that polymorphisms in these vitamin metabolism genes play an etiologic role. Genet. Epidemiol. 2009. © 2008 Wiley Liss, Inc.     

Maternal smoking and environmental tobacco smoke exposure and the risk of orofacial clefts

BACKGROUND: Smoking during pregnancy has been associated with orofacial clefts in numerous studies. However, most previous studies have not been able to assess the relation between maternal smoking and specific phenotypes (eg, bilateral clefts). METHODS: We examined the association between periconceptional maternal smoking, environmental tobacco smoke (ETS) exposure, and cleft lip with or without cleft palate (CLP) (n = 933) and cleft palate only (CPO) (n = 528) compared with infants with no major birth defects (n = 3390). Infants were born between 1 October 1997 and 31 December 2001, and exposures were ascertained from maternal telephone interviews for the National Birth Defects Prevention Study. We excluded infants who had a first-degree relative with an orofacial cleft. Effect estimates were adjusted for folic acid use, study site, prepregnancy obesity, alcohol use, gravidity, and maternal age, education, and race/ethnicity. RESULTS: Periconceptional smoking was associated with CLP (odds ratio = 1.3; 95% confidence interval = 1.0-1.6), and more strongly associated with bilateral CLP (1.7; 1.2-2.6), with a weaker association observed for CPO. Heavy maternal smoking (25+ cigarettes/day) was associated with CLP (1.8; 1.0-3.2), bilateral CLP (4.2; 1.7-10.3), and CPO with Pierre Robin sequence (2.5; 0.9-7.0). ETS exposure was not associated with CLP or CPO. CONCLUSIONS: This study confirmed the modest association between smoking and orofacial clefts that has been consistently reported, and identified specific phenotypes most strongly affected.