深圳龙华区孕妇血清维生素Ｄ水平及其受体基因rs2228570多态性与子痫前期易感性相关性研究

目的　了解深圳龙华区子痫前期（preeclam psia，PE）孕妇血清中1，25-二羟基维生素D31，25-（OH）2 Vit D3]水平及其受体（VDR）基因rs2228570多态性分布情况，并探讨其与深圳龙华区PE发病的易感性。方法　收集2019年3月～2020年12月在深圳市龙华区人民医院妇产中心就诊并确诊为PE孕妇87例作为PE组，120例健康孕妇作为对照组。分别检测血清中1，25-（OH）2Vit D3水平，同时对VDR基因rs2228570多态性进行分析。结果　PE组1，25-（OH）2Vit D3水平（21.67±5.86 nmol/L）明显低于对照组（37.29±7.65 nmol/L），差异有统计学意义（t=4.082 5，P=0.032 7）。重度PE孕妇1，25-（OH）2Vit D3水平（15.87±3.24 nmol/L）明显低于轻度PE孕妇（26.95±6.43 nmol/L），差异有统计学意义（t=3.512 7，P=0.035 2）。经Spearman相关性分析，PE组孕妇1，25-（OH）2Vit D3水平与PE病情严重程度呈负相关（r=-0.612 4，P=0.05）。PE组VDR基因rs2228570位点CC基因型及C等位基因频率（65.52%和77.59%）明显高于对照组（29.17%和42.50%），差异有统计学意义（χ2=7.280 3和5.102 8，均P<0.05）。CC基因型及C等位基因孕妇患PE的相对风险增加（OR=1.928，95%CI:1.503~2.617和OR=1.643，95％CI:1.204~1.921），而TT基因型及T等位基因孕妇患PE的相对风险降低（OR=0.529，95%CI:0.326~0.793和OR=0.671，95％CI:0.485~0.916）。重度PE孕妇CC基因型及C等位基因频率（74.36%和84.62%）高于轻度PE孕妇（58.34%和71.87%），差异有统计学意义（χ2=2.594 3和2.976 0，均P<0.05）。PE组CC基因型孕妇1，25-（OH）2Vit D3水平（13.78±2.91 nmol/L）明显低于CT和CC基因型孕妇（23.84±6.37 nmol/L和25.06±6.72 nmol/L），差异均有统计学意义（t=3.920 4和4.271 5，均P<0.05），但CT和TT基因型孕妇之间差异无统计学意义（t=0.970 3，P=0.152 8）。结论　PE孕妇1，25-（OH）2Vit D3水平明显降低，与PE病情严重程度呈负相关。同时VDR基因rs2228570位点存在多态性分布，其中CC基因型可能是深圳地区PE孕妇危险易感基因之一。

Study on the Correlation between Serum Vitamin D Level and rs2228570Polymorphism of Its Receptor Gene and Preeclampsia Susceptibility inPregnant Women in Shenzhen Longhua District

Objective　To investigate the serum levels of 1, 25-dihydroxyvitamin D31,25 - (OH)2Vit D3] and the polymorphismdistribution of VDR gene rs2228570 in pregnant women with preeclampsia (PE) in Shenzhen Longhua District, and explore itsrelationship with susceptibility to PE in Shenzhen Longhua District. Methods　87 pregnant women diagnosed with PE whowere admitted to the Department of Obstetrics and Gynecology Center of Longhua District People’s Hospital of Shenzhen fromMarch 2019 to December 2020 were selected as the PE group and 120 healthy pregnant women was selected as the control group.Serum levels of 1,25-(OH)2Vit D3 were detected, and VDR gene rs2228570 polymorphism was detected. Results　The level of1,25-(OH)2Vit D3 in PE group (21.67±5.86 nmol/L) was significantly lower than that in control group (37.29±7.65 nmol/L),and the difference was statistically significant (t=4.082 5,P=0.032 7). The level of 1,25-(OH)2Vit D3 in pregnant women withsevere PE (15.87±3.24 nmol/L) was significantly lower than that in pregnant women with mild PE (26.95±6.43 nmol/L), thedifference was statistically significant (t=3.512 7,P=0.035 2). Spearman correlation analysis showed that the level of1,25-(OH)2Vit D3 was negatively correlated with the severity of PE in pregnant women in PE group (r= -0.612 4，P=0.05).The CC genotype and C allele frequencies of VDR rs2228570 locus in PE group were significantly higher than those in control group(65.52% and 77.59%),the difference was statistically significant(χ2=7.280 3 and 5.102 8，all P<0.05). CC genotype and C allelehad an increased relative risk of developing PE (OR=1.928, 95%CI: 1.503~2.617 and OR=1.643, 95%CI: 1.204~1.921), whileTT genotype and T allele had a decreased relative risk of developing PE (OR=0.529,95%CI: 0.326~0.793 and OR=0.671, 95%CI:0.485~0.916). CC genotype and C allele frequency (74.36% and 84.62%) were higher in severe PE women than those in mild PEwomen (58.34% and 71.87%), and the difference was statistically significant (χ2=2.594 3 and 2.976 0, all P<0.05). The level of1,25-(OH)2Vit D3 in pregnant women with CC genotype in PE group (13.78±2.91 nmol/L) was significantly lower than that inpregnant women with CT genotype and CC genotype (23.84±6.37 nmol/L and 25.06±6.72 nmol/L), the difference wasstatistically significant (t=3.920 4 and 4.271 5, all P<0.05), but there was no statistically significant difference between pregnantwomen with CT and TT genotype (t=0.970 3, P=0.152 8). Conclusion　The level of 1,25-(OH)2Vit D3 in pregnant women withPE was significantly decreased, which was negatively correlated with the severity of PE. At the same time, VDR gene rs2228570has polymorphism distribution, and CC genotype may be one of the risk susceptibility genes of PE pregnant women inShenzhen area.