Association between angiotensin converting enzyme gene polymorphism (rs4343) and susceptibility to gestational hypertension and preeclampsia in pregnant women

Abstract

Hypertension is the most frequent medical complication of pregnancy, and the most severe clinical presentation of hypertensive disorders of pregnancy (HDP) is preeclampsia (PE). PE is a condition significantly associated with maternal and perinatal morbidity and mortality. The etiology of PE remains unknown. However, it has been found that genetic factors cause a defective immune adaptation, which in turn leads to inadequate trophoblast invasion and inappropriate placenta development. This study involved 30 patients with gestational hypertension (GH), 30 patients with PE and 30 normotensive pregnant women as controls. We aimed to evaluate the association between the angiotensin-converting enzyme (ACE) gene polymorphism (rs4343) and susceptibility to GH and PE. Genotyping for rs4343 polymorphism was performed by real-time polymerase chain reaction. The differences of genotypes and allele frequencies were analyzed as well as the relationship between ACE polymorphism and susceptibility to PE. The GG genotype of ACE gene rs4343 and G allele frequency were significantly associated with increased risk of PE [OR (95% CI) 10.3125 (2.1043 to 50.5388), p=0.004 and OR (95% CI) 3.4714 (1.6352 to 7.3697), p = 0.001, respectively]. Also, G allele frequency was significantly associated with severity of PE [OR (95% CI) 15.5455 (1.8938 to 127.6075), p = 0.011]. However, the GG genotype and G allele frequency were not associated with GH. In conclusion, ACE rs4343 polymorphism may be associated with PE susceptibility and severity but not with GH.