Preeclampsia In Chinese Women Research Articles

Association of age at menarche with gestational hypertension and preeclampsia: A large prospective cohort in China.

This study explored the potential association between age at menarche and the risks of gestational hypertension and preeclampsia in Chinese women. Data were sourced from the China-US Collaborative Project for Neural Tube Defects Prevention, a large population-based cohort study. Our study consisted of 209411 women pre-registered for pregnancy in two provinces in South China. Trained healthcare workers measured blood pressure at registration and recorded other pertinent health information. Using logistic regression, we assessed the correlations between age at menarche and the likelihood of developing gestational hypertension and preeclampsia, considering confounders such as maternal age, body mass index, ethnicity, parity, folic acid supplementation, education level, and occupation. The observed incidences for gestational hypertension and preeclampsia were 9.65% and 2.54%, respectively. The adjusted odds ratios (ORs) for gestational hypertension, based on age at menarche, were as follows: ≤13 years, 1.18 (95% confidence interval: 1.11-1.26); 14 years, 1.09 (1.04-1.15); 15 years, 1.11 (1.06-1.16); 16 years, 1.06 (1.01-1.12); and ≥17 years, 1.00 (reference; P for trend<.001). The correlation between age at menarche and preeclampsia varied across age groups, with the following respective ORs: 1.35 (1.20-1.52), 1.21 (1.09-1.34), 1.27 (1.15-1.39), 1.14 (1.03-1.26), and 1.00 (reference; P for trend<.001). This association appeared to be more pronounced in women with no folic acid supplementation and those with a lower education level. In conclusion, an earlier age at menarche seems to be linked to increased risks of gestational hypertension and preeclampsia.

Association between genetic polymorphisms of leptin receptor and preeclampsia in Chinese women

Objective Leptin signaling plays an important role in regulating metabolism and reproduction. In the present study, we investigated the relationship between polymorphisms of leptin receptor (LEPR) gene A223G and A668G and preeclampsia (PE) and evaluated influences of genotypes on clinical, metabolic, and oxidative stress indices in Chinese women. Methods This is a case-control study including 322 patients with PE and 1295 healthy pregnant women. The two polymorphisms were genotyped by polymerase chain reaction-restriction fragments length polymorphism method. Clinical and biochemical parameters were analyzed. Results The frequencies of the AA + AG genotypes (28.6% vs. 36.1%) and A allele (14.9% vs. 19.8%) of LEPR A223G polymorphism, and those of the AA + AG genotypes (17.7% vs. 24.6%) and A allele (9.0% vs. 12.9%) of LEPR A668G polymorphism were significantly lower in the PE group than those in the control group. The 223A and 668A alleles were protective factors against PE in the regression model, which included age and delivery body mass index as covariates (OR = 0.684, 95% CI: 0.506–0.926, p = .014; OR = 0.650, 95% CI: 0.456–0.927, p = .017, respectively). When the 668GG/223GG combined genotype served as the reference category, the 668A/223A combined allele had further enhanced the protective effect on PE (OR = 0.558, 95% CI: 0.374–0.833, p = .004). Patients possessing the LEPR 223A allele had higher total antioxidant capacity and lower oxidative stress index (p < .05), while those with the LEPR 668A allele had higher high-density lipoprotein cholesterol levels (p = .045) compared with those carrying the corresponding GG genotype. Conclusions The 223A and 668A alleles of LEPR polymorphisms are genetic protective factors for PE in Chinese women. The two alleles may exert a beneficial effect on oxidative stress and lipid metabolism in patients.

Association of CYBA C242T and superoxide dismutase 2 A16V genetic variants with preeclampsia.

To investigate the relationship between NADPH oxidase p22phox subunit (CYBA; C242T) and superoxide dismutase 2 (SOD2; A16V) polymorphisms and the risk of preeclampsia (PE) in Chinese women. This case-control study included 325 patients with PE and 1294 controls. The genotypes were determined by polymerase chain reaction-restrictionfragmentslengthpolymorphism method. Clinical, metabolic, and oxidative stress parameters were analyzed. Participants with T allele of the CYBA C242T polymorphism had a decreased risk of PE (OR=0.62, 95% CI: 0.42-0.92, P=0.016) and those with the A allele of the SOD2 A16V polymorphism had increased risk of PE (OR=1.44, 95% CI: 1.09-1.89, P=0.010). The coexistence of the SOD2 AA+AV genotypes and the CYBA CC genotype further increased the risk of PE (OR=2.32, 95% CI: 1.31-4.10, P=0.003) when the CT+TT/VV combined genotype was the reference category. The T allele of the CYBA C242T polymorphism is related to a decreased risk of PE, while the A allele of the SOD2 A16V polymorphism and its combination with the CYBA CC genotype are associated with an increased risk of PE in Chinese women.

Short-Term Prediction of Preeclampsia in Chinese Women Using the Soluble fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio: A Sub-Analysis of the PROGNOSIS Asia Study.

The diagnosis of preeclampsia in China currently relies on limited clinical signs and unspecific laboratory findings. These are inadequate predictors of preeclampsia development, limiting early diagnosis and appropriate management. Previously, the Prediction of Short-Term Outcome in Pregnant Women with Suspected Preeclampsia Study (PROGNOSIS) and PROGNOSIS Asia demonstrated that a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio of ≤38 can be used to rule out preeclampsia within 1 week, with negative predictive values of 99.3 and 98.6%, respectively. This is an exploratory sub-analysis of the Chinese cohort (n = 225) of the PROGNOSIS Asia study. The primary objectives were to assess the predictive performance of using the sFlt-1/PlGF ratio to rule out preeclampsia within 1 week and to rule in preeclampsia within 4 weeks. The sFlt-1/PlGF ratio was also examined for short-term prediction of fetal adverse outcomes, maternal adverse outcomes, and time to delivery. The overall prevalence of preeclampsia was 17.3%. With the use of an sFlt-1/PlGF ratio of ≤38, the negative predictive value for ruling out preeclampsia within 1 week was 97.3% [95% confidence interval (CI), 93.8–99.1], with a sensitivity of 64.3% and specificity of 85.3%. With the use of an sFlt-1/PlGF ratio of >38, the positive predictive value for ruling in preeclampsia within 4 weeks was 35.0% (95% CI, 20.6–51.7), with a sensitivity of 50.0% and specificity of 86.8%. In the analyses of the sFlt-1/PlGF ratio and fetal adverse outcomes, the area under the receiver operating characteristic curve was 92.8% (95% CI, 83.5–98.7) for ruling out fetal adverse outcomes within 1 week and 79.9% (95% CI, 68.1–90.3) for ruling in fetal adverse outcomes within 4 weeks. An sFlt-1/PlGF ratio of >38 increased the likelihood of imminent delivery 3.3-fold compared with a ratio of ≤38 [hazard ratio, 3.3 (95% CI, 2.1–5.1)]. This sub-analysis confirms the high predictive performance of the sFlt-1/PlGF ratio cutoff of 38 for short-term prediction of preeclampsia in Chinese women, which may help prevent unnecessary hospitalization of women with low risk of developing preeclampsia.

Preconception blood pressure and risk of gestational hypertension and preeclampsia: a large cohort study in China.

Our objective was to examine whether high blood pressure in the preconception period was associated with gestational hypertension and preeclampsia in Chinese women. Data were obtained from the China-US Collaborative Project for Neural Tube Defects Prevention, a large population-based cohort study. We included 45,628 women who were registered before pregnancy in seven counties in South China. Blood pressure was measured during registration by trained health care workers, and other health-related information was recorded prospectively. We used logistic regression to evaluate the associations between preconception blood pressure and the risk of gestational hypertension and preeclampsia, adjusting for potential confounders. The prevalence of hypertension in the preconception study population was 4.57% (2083/45,628). The incidences of gestational hypertension and preeclampsia were 11.95% and 4.08%, respectively, in the hypertension group and 8.60% and 2.28%, respectively, in the nonhypertension group. Compared with the nonhypertension group, the hypertension group showed a significantly increased risk for gestational hypertension [adjusted risk ratio (RR) = 1.40, 95% confidence interval (CI): 1.22-1.60] and preeclampsia [adjusted RR = 1.75, 95% CI: 1.39-2.19]. When participants with normal blood pressure were used as the reference, the adjusted ORs for gestational hypertension were 1.48 (95% CI: 1.37-1.59), 1.70 (95% CI: 1.44-2.01), and 1.29 (95% CI: 1.02-1.64), and for preeclampsia, the adjusted ORs were 1.55 (95% CI: 1.35-1.78), 1.95 (95% CI: 1.46-2.60), and 1.99 (95% CI: 1.39-2.85) for the participants with prehypertension, stage 1 hypertension, and stage 2 hypertension, respectively. Our results support an association between hypertension or higher blood pressure prior to pregnancy and an increased risk of gestational hypertension and preeclampsia.

Association of the G994T and R92H genotypes of platelet-activating factor acetylhydrolase with risk of preeclampsia in Chinese women.

To investigate the relationship between platelet-activating factor acetylhydrolase (PAF-AH) gene (PLA2G7) G994T (V279F, rs76863441) and R92H (rs1805017) polymorphisms and risk of preeclampsia (PE) in Chinese women. This is a case-control study of 273 patients with PE and 530 healthy pregnant women. PLA2G7 genotypes were determined by polymerase chain reaction amplification and restriction analysis. Plasma PAF-AH, apolipoprotein (apo) B-containing lipoprotein-associated PAF-AH (apoB-PAF-AH), total high-density lipoprotein (HDL)-associated PAF-AH (H-PAF-AH), apoE-containing HDL-associated PAF-AH (apoE-H-PAF-AH) activities, and clinical, metabolic, and oxidative stress parameters were also analyzed. The frequencies of the GT+TT genotype (14.7 versus 9.2%, P=0.019) and T allele (7.5% versus 4.6%) of PLA2G7 G994T polymorphism were significantly higher in patients with PE than in the control subjects. The GT+TT genotypes remained a significant predictor for PE in a regression model including age, body mass index (BMI), plasma PAF-AH, H-PAF-AH, apoE-H-PAF-AH and apoB-PAF-AH activities as covariates (odds ratio (OR)=4.926, 95% confidence interval (CI): 1.707-14.219, P=0.003). The ratio of apoB-PAF-AH to H-PAF-AH activities was significantly higher, while serum triglyceride levels were lower in patients with the GT genotype compared with patients with the GG genotype (P<0.05). No significant differences were observed in the frequencies of the R92H genotype and allele between the PE and control groups. The PLA2G7 G994T, but not R92H, genetic polymorphism is associated with the risk of PE in Chinese women.

Investigation heme oxygenase-1 polymorphism with the pathogenesis of preeclampsia

ABSTRACTObjectives: The involvement of oxidative stress in the pathophysiology of preeclampsia (PE) has been already suggested. In this present study, we aimed to investigate the association of the genetic frequency of heme oxygense-1 (HMOX1) polymorphism with PE in Chinese Han women.Methods: We researched the genetic distribution of rs2071746 polymorphism in HMOX1 by the TaqMan allelic discrimination real-time PCR between 1235 PE patients and 1720 healthy women.Results: We found there were′t significant differences in the distribution of HMOX1 rs2071746 polymorphism in PE compared to the control group (rs2071746, genotype χ2 = 0.282, P = 0.869 and allele χ2 = 0.027, P = 0.869, OR = 1.009, 95% = 0.909–1.120).Conclusion: The rs2071746 polymorphism in HMOX1 might not be related to PE in Chinese women, although further investigations should be conducted to confirm our findings.

Hypertension in black patients

To investigate the relationship between platelet-activating factor acetylhydrolase (PAF-AH) gene (PLA2G7) G994T (V279F, rs76863441) and R92H (rs1805017) polymorphisms and risk of preeclampsia (PE) in Chinese women.This is a case-control study of 273 patients with PE and 530 healthy pregnant women.PLA2G7 genotypes were determined by polymerase chain reaction amplification and restriction analysis. Plasma PAF-AH, apolipoprotein (apo) B-containing lipoprotein-associated PAF-AH (apoB-PAF-AH), total high-density lipoprotein (HDL)-associated PAF-AH (H-PAF-AH), apoE-containing HDL-associated PAF-AH (apoE-H-PAF-AH) activities, and clinical, metabolic, and oxidative stress parameters were also analyzed.The frequencies of the GT + TT genotype (14.7 versus 9.2%, P = 0.019) and T allele (7.5% versus 4.6%) of PLA2G7 G994T polymorphism were significantly higher in patients with PE than in the control subjects. The GT + TT genotypes remained a significant predictor for PE in a regression model including age, body mass index (BMI), plasma PAF-AH, H-PAF-AH, apoE-H-PAF-AH and apoB-PAF-AH activities as covariates (odds ratio (OR) = 4.926, 95% confidence interval (CI): 1.707–14.219, P = 0.003). The ratio of apoB-PAF-AH to H-PAF-AH activities was significantly higher, while serum triglyceride levels were lower in patients with the GT genotype compared with patients with the GG genotype (P < 0.05). No significant differences were observed in the frequencies of the R92H genotype and allele between the PE and control groups.The PLA2G7 G994T, but not R92H, genetic polymorphism is associated with the risk of PE in Chinese women.

Association between COMT Val158Met polymorphism and preeclampsia in the Chinese Han population

ABSTRACTObjective: Previous studies have been indicated that catechol-O-methyltransferase gene (COMT) might play a significant role in the development of preeclampsia (PE). Our study aims to investigate the association between polymorphism in COMT with the susceptibility to PE in Chinese Han women. Method: A total of 1028 PE patients and 1399 normal pregnant women were enrolled. We detected the genotyping of COMT Val158Met loci by the TaqMan allelic discrimination real-time PCR . Results: No significant difference in the genotypic and allelic distribution was found between the two groups (genotype: X2 = 0.583, p = 0.747; allele:X2 = 0.526, p = 0.468). Conclusion: The COMT Val158Met polymorphism might not be associated with PE in Chinese women.

Association of gene polymorphisms of FV, FII, MTHFR, SERPINE1, CTLA4, IL10, and TNFalpha with pre-eclampsia in Chinese women.

To investigate the association of polymorphisms in genes involved in coagulation, fibrinolysis, and inflammation with pre-eclampsia (PE) in a Chinese population. It is a case-control study of patients with PE (n=117) and controls (n=286) from the Maternal and Children's Hospital of Shenzhen City carried out between June 2014 and May 2015. The rs6025, rs6020, rs1801133, rs1799963, rs1799889, rs231775, rs1800896, rs1800629, and rs1799724 polymorphisms were analyzed using Snap Shot. Multifactor dimensionality reduction (MDR) and logistic regression analyses were carried out to assess the interactions among these SNPs. The frequencies of polymorphisms in tumor necrosis factor-α (TNF-α) (rs1800629 and rs1799724) and interleukin 10 (IL-10) (rs1800896) were significantly different between patients with PE and controls (P<0.05). The best interaction model identified a marginally significant interaction between rs1799724 and rs1800896 (P=0.05). This study suggests that polymorphisms in the TNF-α and IL-10 genes could be associated with PE, but additional studies are necessary to explore the mechanisms involving these polymorphisms and the gene-gene interactions involved in the susceptibility to PE.

Effects of acupuncture on preeclampsia in Chinese women: a pilot prospective cohort study.

To investigate the acceptability and feasibility of acupuncture treatment as an adjunct to usual care in Chinese women with preeclampsia. This was a pilot prospective cohort study. Pregnant women with a diagnosis of preeclampsia were offered acupuncture and allocated into groups based on their choice: the acupuncture group (n=11) comprised women electing to receive treatment (up to 10 sessions over 2 weeks). The control group (n=11) was made up of women who declined and was matched for age, gestation at diagnosis, and parity. All women received usual care and underwent measurement of blood pressure (BP) at four time points: at baseline, at the end of the intervention, immediately before delivery, and postpartum (within 24 h). Patients in the acupuncture group had significantly lower BP at time of delivery, and postpartum, than patients in the control group (p<0.05). The individual change in BP between baseline and the end of treatment was significantly greater in the acupuncture group versus the control group for both systolic BP (median (IQR) -8 (-3 to -14) vs +1 (-7 to +9) mm Hg, p=0.007) and diastolic BP (-3 (-1 to -3) vs +2 (-2 to +7) mm Hg, p=0.013). There were no significant differences between the groups in perinatal outcomes and no adverse effects of treatment. Acupuncture plus usual care was associated with a greater reduction in BP than usual care alone. Further studies are needed to clarify the role of acupuncture in the treatment of preeclampsia.

Investigation of the association between matrix metalloproteinase-9 genetic polymorphisms and development of pre-eclampsia in Chinese pregnant women

We carried out a case-control study to evaluate the role of MMP-9 -1562 C/T (rs3918242) genetic polymorphism in the risk of pre-eclampsia in Chinese pregnant women. Between March 2013 and January 2015, 107 pregnant women with pre-eclampsia were recruited from the Second Affiliated Hospital of Zhengzhou University. Genotyping of MMP-9 was carried out using polymerase chain reaction-restriction fragment length polymorphism assay. Unconditional logistic regression analyses revealed that women with the CT genotype (OR = 1.81, 95%CI = 1.04-3.11) exhibited significantly higher risk of pre-eclampsia than those with the wild-type CC genotype. Moreover, individuals carrying the T allele were at higher risk of pre-eclampsia than those carrying the C allele; the adjusted OR (95%CI) was 1.62 (1.06-2.47). In conclusion, our study demonstrated that the MMP-9 -1562 C/T polymorphism plays an important role in the development of pre-eclampsia in Chinese women. Further studies with large sample sizes are greatly needed to confirm our findings.

ADIPOQ +45T&gt;G, +712A&gt;G and +4545C&gt;G variants are associated with dyslipidemia in Chinese pre-eclampsia women

The pathogenesis of pre-eclampsia, the most common complication in obstetrics, is unclear. Family based studies have shown that the incidence of pre-eclampsia is related to genetic factors. Lipid profile indicated that pre-eclampsia were also accompanied by dyslipidemia. We would like to evaluate the influence of common polymorphisms of the adipose most abundant gene transcript-1, adiponectin (ADIPOQ) gene on the lipid metabolism, and pre-eclampsia in Chinese Han women of pregnancy. Clinically defined pre-eclampsia patients (n = 221) and healthy pregnant women (n = 271) were recruited. PCR-RFLP was used to genotype ADIPOQ +45T/G, +712A/G, and +4545C/G single-nucleotide polymorphisms (SNPs). Changes in metabolic and clinical data were analyzed according to SNPs and groups. +45TT genotype had a relatively lower ApoA1 level than G-allele carrier in case group (p = 0.002). In the controls, systolic blood pressure (SBP) levels were higher in +712AA genotype group than G-allele carriers’ (p = 0.009), +4545CC were higher than G-allele carriers’ (p = 0.009). No significant association between the ADIPOQ genotype or the alleles and pre-eclampsia had been observed. There is a strong linkage disequilibrium between polymorphic loci +45T>G and +712A>G, +45T>G and +4545T>G, and +712A>G and +4545T>G, respectively. ADIPOQ gene might affect SBP and lipid metabolism of pre-eclampsia, although the three polymorphic sites on ADIPOQ gene are not the major genetic determinants of susceptibility to pre-eclampsia in Chinese women.

The complication and mode of delivery in Chinese women with severe preeclampsia: a retrospective study

Objective: Severe preeclampsia is a serious threat for pregnant women and fetuses. The complications of severe preeclampsia greatly affect perinatal outcome. This study aimed to investigate the complication and delivery mode of Chinese pregnant women with severe preeclampsia, and analyze the change in these aspects in the past decades. Methods: Clinical data of 1713 pregnant women with severe preeclampsia were collected and analyzed. The patients were divided into two groups: early period (1985–1997) and later period (1998–2010). Results: The complications for severe preeclampsia included preterm birth, fetal distress, postpartum hemorrhage, fetal growth restriction (FGR). Compared to early period, the rates of preterm birth, FGR, oligohydramnios, abnormal pregnancy outcome increased while the rates of fetal distress, postpartum hemorrhage and eclampsia decreased in later period. The rate of cesarean section was 73.073% in the early period and increased to 88.258% in the later period. Accordingly, the rate of natural childbirth, forceps extraction, vacuum extraction and breech extraction decreased in the later period. Conclusions: Our data provide important information on the complication and mode of delivery in Chinese women with severe preeclampsia in the past decades, which may be helpful for clinical management of severe preeclampsia in Chinese women.

Association of Angiotensinogen Gene Polymorphisms and Angiogenic Factors with Preeclampsia in Chinese Women

Objective: To investigate the association of angiotensinogen (AGT) gene polymorphisms and angiogenic factors with preeclampsia (PE) in Chinese women. Methods: A study on Chinese women was performed. Detection of the M235T polymorphism of AGT gene was carried out by PCR. Using a χ² test, genotype and allele frequencies were compared in all groups. Maternal serum levels of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt1) at gestation were compared between 92 women with PE and 100 controls by ELISA. Results: Compared to the controls, the AGT homozygous of TT genotype in PE occurred significantly more frequently and the T allele was observed to occur more frequently than the M allele (p < 0.05). sFlt1 was present in high quantities in the serum of women with PE and was associated with low levels of free VEGF and PlGF (p < 0.05). Plasma sFlt1 levels are higher in PE patients with TT heterozygotes compared with MM homozygotes, but PIGF is lower (p < 0.05). Plasma VEGF concentrations showed no significant difference. Conclusions: Our study showed that AGT M235T polymorphism is associated with PE in Chinese women. Furthermore, the gene polymorphism of the components of the renin-angiotensin system may contribute to the concentration alterations of sFlt1, VEGF, and PlGF in maternal serum, which causes disordered vasculogenesis contributing to PE.

High leptin level and leptin receptor Lys656Asn variant are risk factors for preeclampsia

The aim of this study was to investigate the relationship between the leptin receptor (LEPR) polymorphism/serum leptin level and preeclampsia. The prevalence of a single nucleotide polymorphism in the LEPR gene exon 14 at -656 and the serum leptin concentrations in 97 preeclamptic pregnant mothers were compared to those of 110 healthy controls. The Lys656Asn genotype and Lys656Asn + Asn656Asn frequencies in the LEPR gene were significantly more prevalent in preeclampsia mothers than in controls (P < 0.05). The serum leptin levels of preeclampsia cases were significantly higher than those of controls. In addition, there were higher serum leptin levels in individuals with the GC + CC genotype both in the total cohort and in women with preeclampsia than in those with the GG genotype. Our findings suggest that the Lys656Asn polymorphism is a functional variant in the LEPR, which can affect the interaction of leptin and its receptor. Furthermore, high leptin level and the LEPR variant are risk factors for preeclampsia in Chinese women.

Meta analysis of angiotensin-converting enzyme I/D polymorphism as a risk factor for preeclampsia in Chinese women

Preeclampsia affects 3-8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality worldwide. Inappropriate activation of the renin-angiotensin system may play a role in the development of preeclampsia. An insertion/deletion polymorphism in the angiotensin-converting enzyme gene (ACE-I/D) has been associated with differences in ACE activity. However, there are controversies in reports on the association of ACE-I/D with preeclampsia. Data were analyzed using Review Manager Version 5.0 and a random effects model was applied irrespective of between studies heterogeneity, which was evaluated via sensitivity and subgroup analyses. Publication bias was evaluated using the fail-safe number. A systematic search was performed based on published case control studies up to October 1, 2011, and 11 studies were included, involving 800 patients and 949 controls. Significant association of the ACE D allele with increase risk of preeclampsia was found (odds ratio = 1.93, 95% confidence interval = 1.19-3.12; P = 0.008). Sensitivity analysis showed that no individual study had an undue influence on the summary odds ratios for all contrasts. An analysis stratified by study size showed an attenuated odds ratio towards a null effect as study size increased. Based on our meta-analysis, we suggest that the D allele of the ACE gene is related with increased risk for preeclampsia in the Chinese population. Considering the potential existence of small study bias, further research should be performed with a larger dataset.

Association between osteoprotegerin gene polymorphisms and severe pre-eclampsia in Chinese women

To investigate the potential association between 163A/G and 950T/C polymorphisms of osteoprotegerin (OPG) gene and severe pre-eclampsia. Eighty-five severe pre-eclamptic patients and 81 normal term pregnant women (as control group) were recruited from the Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University during the period from July 2007 to March 2009, and they were all Han population living in Chengdu, China. Genotype and allele frequencies of 163A/G and 950T/C were determined by the PCR-restriction fragment length polymorphism (RFLP) assay. Clinical and biochemical parameters for different alleles between the patients and controls were compared for statistical significance respectively, such as blood pressure, serum creatinine and 24-hour urine protein. The observed and expected genotype counts were consistent with Hardy-Weinberg equilibrium. No significant differences were found in the genotype and allele frequencies of 163A/G and 950T/C polymorphisms between the two groups (P > 0.05). However, in the preeclamptic group, serum creatinine was significantly higher in women with the AG + GG genotypes [(76 ± 24) µmol/L] compared with AA genotype [(56 ± 18) µmol/L]. Reversely, birth weight was lower in the AG + GG genotypes [(2040 ± 721) g] than those in the AA genotype [(2520 ± 810) g], and the P < 0.05, respectively. In the severe pre-eclampsia, 950T/C TT genotype carriers exhibited significantly higher systolic blood pressure [(153 ± 16) mm Hg (1 mm Hg = 0.133 kPa)] and 24-hour urine protein [(4.0 ± 2.5) g] compared with TT + TC carriers [(145 ± 17) mm Hg, (2.9 ± 1.8) g], respectively, furthermore the P < 0.05. In severe pre-eclampsia, carriers with G allele at position 163A/G has more genetic predisposition than A allele carriers, as well as 950T/C T allele carriers compared with C carriers. Taken together, this study suggested that OPG gene polymorphisms might be associated with some clinical parameters of severe pre-eclampsia.

Angiotensin-Converting Enzyme Insertion/Deletion (ACE I/D) and Angiotensin II Type 1 Receptor (AT1R) Gene Polymorphism and Its Association with Preeclampsia in Chinese Women

Objective: To investigate whether polymorphisms of angiotensin converting enzyme gene (ACE) and angiotensin II receptor type 1 gene (AT1R) are associated with etiology of preeclampsia and renal impact in women with preeclampsia. Methods: DNA was extracted from peripheral blood of 133 patients with preeclampsia and 105 healthy pregnant women. The I/D polymorphism of the ACE gene was assessed by polymerase chain reaction, and the A1166C polymorphism of the AT1R gene was additionally assessed by DdeI digestion. The level of proteinuria, fasting serum urea, creatinine and uric acid were investigated according to different genotypes of ACE and AT1R genes. Results: The frequency of genotypes of the ACE gene and the AT1R gene was similar in preeclampsia and normal pregnancy. DD and ID genotype predominated in patients with severe proteinuria, as well as increased serum urea and uric acid. Serum creatinine was also increased, but no significant difference was found among three genotypes. The level of proteinuria, serum uric acid, urea, and creatinine did not vary between different AT1R genotypes. Compared with patients without renal dysfunction, the frequency of DD and ID genotypes of ACE gene was much higher in those with renal dysfunction, but AC and CC genotypes of AT1R gene were not. Conclusion: We found no association of the two gene polymorphisms with preeclampsia. However, ACE gene I/D polymorphisms were associated with the severe proteinuria and renal dysfunction seen in preeclampsia. Preeclampsia patients carrying the D allele may be susceptible to renal dysfunction.