Serum homocysteine and folate concentrations in early pregnancy and subsequent events of adverse pregnancy outcome: the Sichuan Homocysteine study

Abstract

Background: Hyperhomocysteinemia may be a risk factor for endothelial dysfunction. Folate and vitamin B12 regulate the homocysteine metabolic process. This study aimed to evaluate the associations between subsequent events of adverse pregnancy outcome and early variables of homocysteine, folate, and vitamin B12 in pregnant women. Methods: This multicenter, retrospective, case-control study involved 563 pregnant women with adverse pregnancy outcome and 600 controls. Adverse pregnancy outcomes included one or more of the following events: preeclampsia, preterm birth, low birth weight, and stillbirth. The associations between subsequent events of adverse pregnancy outcome and early variables of homocysteine, folate, and vitamin B12; metabolic parameters; inflammatory markers; anthropometrics; and lifestyle habits at 11-12 weeks of gestation were analyzed using the logistic regression model. Results: Compared to the lower quartile homocysteine concentrations, the upper quartile homocysteine concentrations were associated with preeclampsia, preterm birth and low birth weight. On the contrary, the lower quartile folate concentrations were associated with preeclampsia, preterm birth and low birth weight compared with the upper quartile folate concentrations. The incidence of adverse pregnancy outcome increased progressively from the first to fourth homocysteine quartiles but decreased progressively from the first to fourth folate quartiles. After adjusting for confounding factors, multivariate logistic regression analysis showed that besides systolic blood pressure, diastolic blood pressure, body mass index and age, homocysteine (IV vs I quartile, aOR 5.89, 95% CI 4.08-8.51, P < 0.001), folate (IV vs I quartile, aOR 0.35, 95% CI 0.25-0.50, P < 0.001), folate supplementation (yes vs no, aOR 0.55, 95% CI 0.35-0.86, P = 0.010) during early pregnancy were independently associated with subsequent events of adverse pregnancy outcome, and vitamin B12 was rejected. Of these, the homocysteine revealed the highest odds ratio in all risk variables, and folate showed the lowest odds ratio in all protective variables.

Establishment of assay method- and trimester-specific reference intervals for thyroid hormones during pregnancy in Chengdu, China

“…Another group of 8646 non-pregnant women who were receiving a pre-pregnancy clinical and laboratory tests at our hospital during the same period were recruited as the controls. Pre-pregnancy clinical and laboratory tests is a comprehensive examination for every couple of childbearing age, which is provided by the government in Chengdu, China, including some free items such as thyroid hormone, fasting plasma glucose and so on [12].…”

“…Hypercholesterolemia and hypertriglyceridemia, low HDL-C level, and high LDL-C level were de ned as TC ≥ 6.22 mmol/L and TG ≥ 2.26 mmol/L, HDL-C < 1.04 mmol/L, and LDL-C ≥ 4.14 mmol/L, respectively, according to the Chinese guidelines on the prevention and treatment of dyslipidemia in adults [15,16]. Gestational diabetes was diagnosed when patients' FPG was ≥ 5.1 mmol/L, and/or 1-h plasma glucose (1hPG) during an oral glucose tolerance test (OGTT) ≥ 10.0 mmol/L, and/or 2-h plasma glucose (2hPG) during an OGTT ≥ 8.5 mmol/L, according to the 2010 International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classi cation of hyperglycemia in pregnancy [17].…”

Association Study of MTHFR C677T Polymorphism and Birth Body Mass With Risk of Autism in Chinese Han Population

“…Another explanation is that MTHFR enzyme activity is reduced due to MTHFR C677T, which may cause the deficiency of folate. Folate deficiency is a modifiable nutritional status that has been linked with adverse pregnancy outcomes including low birth body mass ( 57 , 58 ). Thus, the gene–environmental interaction between MTHFR 677T risk allele and low birth body mass may further increase the susceptibility of autism.…”

Clinical implication of homocysteine in premature acute coronary syndrome female patients

“…Patients were categorized into 4 groups according to the Hcy level: quartile 1 (Q1): 4.4 to 9.2 μmol/L, quartile 2 (Q2): 9.2 to 11.3 μmol/L, quartile 3 (Q3): 11.3 to 14.1 μmol/L, and quartile 4 (Q4): 14.1 to 64.0 μmol/L. [ 17 , 18 ] Comparison of accumulating MACE occurrence among 4 groups (Q1/Q2/Q3/Q4) was determined by log-rank test. P value < .05 was considered statistically significant.…”