普通叶酸与活性叶酸补充对于MTHFR 677TT型不明原因反复流产患者红细胞叶酸水平的影响

doi:10.3969/j.issn.1674-8115.2024.06.009

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (6): 741-745.doi: 10.3969/j.issn.1674-8115.2024.06.009

普通叶酸与活性叶酸补充对于MTHFR 677TT型不明原因反复流产患者红细胞叶酸水平的影响

卢永杰¹(), 侯树辰², 常亮¹(), 刘平¹

^1.北京大学第三医院妇产科，生殖医学中心，女性生育力促进全国重点实验室，国家妇产疾病临床医学研究中心（北京大学第三医院），辅助生殖教育部重点实验室（北京大学），北京市生殖内分泌与辅助生殖技术重点实验室（北京大学第三医院），北京 100191
^2.北京中医药大学研究生院，北京 100029

收稿日期:2023-12-26 接受日期:2024-06-14 出版日期:2024-06-28 发布日期:2024-06-28
通讯作者: 常亮 E-mail:luyongjieyichuan@163.com;changliangchina@163.com
作者简介:卢永杰（1988—），男，助理研究员，博士；电子信箱：luyongjieyichuan@163.com。
基金资助:
北京大学临床医学+X青年专项(PKU2023LCXQ039);辅助生殖教育部重点实验室（北京大学）开放课题(BYSYSZKF2023003);国家妇产疾病临床医学研究中心（北京大学第三医院）开放课题(BYSYSZKF2021004)

Impact of folic acid and active folate supplementation on red blood cell folate levels in patients with unexplained recurrent pregnancy loss and MTHFR 677TT genotype

LU Yongjie¹(), HOU Shuchen², CHANG Liang¹(), LIU Ping¹

^1.State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital); Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education Beijing; Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
^2.Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China

Received:2023-12-26 Accepted:2024-06-14 Online:2024-06-28 Published:2024-06-28
Contact: CHANG Liang E-mail:luyongjieyichuan@163.com;changliangchina@163.com
Supported by:
Clinical Medicine Plus X-Young Scholars Project of Peking University(PKU2023LCXQ039);Funding from Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education(BYSYSZKF2023003);Funding from National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital)(BYSYSZKF2021004)

摘要/Abstract

摘要：

目的·研究普通叶酸与活性叶酸补充对亚甲基四氢叶酸还原酶（methylenetetrahydrofolate reductase，MTHFR）677TT型不明原因反复流产（unexplained recurrent pregnancy loss，URPL）患者红细胞叶酸水平的影响。方法·选取2021年1—12月于北京大学第三医院生殖医学中心就诊的MTHFR 677TT型URPL患者45例。按照叶酸补充方式将其分为3组，包括A组16例（研究开始前尚未接受任何形式的叶酸补充，研究开始后进行活性叶酸补充），B组15例（研究开始前进行过普通叶酸的补充，研究开始后进行活性叶酸补充），以及C组14例（研究开始前进行过普通叶酸的补充，研究开始后进行普通叶酸与活性叶酸联合补充）。分别于入组时（第一次）、入组补充后（第二次）对3组患者的红细胞5-甲基四氢叶酸（5-methyltetrahydrofolate，5-MTHF）浓度进行检测，并开展比较。结果·在3组患者中，任意2组的第一次红细胞5-MTHF浓度间差异均无统计学意义。与第一次红细胞5-MTHF浓度相比，3组患者的第二次红细胞5-MTHF浓度均有提高（均P=0.000），且B组患者的红细胞5-MTHF浓度的增幅高于A组（t=2.373，P=0.049），但与C组间差异无统计学意义。结论·与补充普通叶酸相比，补充活性叶酸可以更好地在短时间内提高MTHFR 677TT型URPL患者的红细胞叶酸水平。

关键词: 亚甲基四氢叶酸还原酶基因, 不明原因反复流产, 5-甲基四氢叶酸

Abstract:

Objective ·To study the effects of folic acid and active folate supplementation on red blood cell folate levels in patients with unexplained recurrent pregnancy loss (URPL) and methylenetetrahydrofolate reductase (MTHFR) 677TT genotype. Methods ·A total of 45 patients with MTHFR 677TT genotype and URPL in the Center for Reproductive Medicine of Peking University Third Hospital from January to December 2021 were selected. They were divided into three groups according to folic acid supplementation, including 16 cases in Group A (who had not received any form of folic acid supplementation before the study began, but received active folic acid supplementation after the study began),15 cases in Group B (who had received ordinary folic acid supplementation before the study began, and active folic acid supplementation after the study began),and 14 cases in Group C (ordinary folic acid was supplemented before the start of the study, and after the start of the study, ordinary folic acid and active folic acid were supplemented together). The concentration of 5-methyltetrahydrofolate (5-MTHF) in red blood cells was measured and compared at the time of enrollment (first measurement) and after supplementation (second measurement). Results ·There was no statistically significant difference in the first measurement of 5-MTHF concentrations in red blood cells between any two groups of patients in the three groups. Compared with the first measurement of 5-MTHF concentrations in red blood cells, the second increased (all P=0.000); the increase in 5-MTHF concentrations in red blood cells in Group B was higher than that in Group A (all P=0.000); the increasing 5-MTHF concentration in Group B was higher than that in Group A (t=2.373, P=0.049), but there was no significant difference between Group B and Group C. Conclusion ·Compared with folic acid supplementation, active folate supplementation can better improve red blood cell folate levels in patients with MTHFR 677TT genotype and URPL in a short period.

Key words: methylenetetrahydrofolate reductase (MTHFR), unexplained recurrent pregnancy loss (UPRL), 5-methyltetrahydrofolate (5-MTHF)

中图分类号:

R714.21

卢永杰, 侯树辰, 常亮, 刘平. 普通叶酸与活性叶酸补充对于MTHFR 677TT型不明原因反复流产患者红细胞叶酸水平的影响[J]. 上海交通大学学报（医学版）, 2024, 44(6): 741-745.

LU Yongjie, HOU Shuchen, CHANG Liang, LIU Ping. Impact of folic acid and active folate supplementation on red blood cell folate levels in patients with unexplained recurrent pregnancy loss and MTHFR 677TT genotype[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(6): 741-745.

图/表 1

参考文献 22

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Group	Concentration 1/(nmol·L^-1)	Concentration 2/(nmol·L^-1)	t value
Group A	427.3±162.6	629.4±243.2	5.033
Group B	356.6±120.1	728.9±253.1	6.159
Group C	377.7±162.5	998.9±444.0	6.202

Group	Concentration 1/(nmol·L^-1)	Concentration 2/(nmol·L^-1)	t value
Group A	427.3±162.6	629.4±243.2	5.033
Group B	356.6±120.1	728.9±253.1	6.159
Group C	377.7±162.5	998.9±444.0	6.202

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普通叶酸与活性叶酸补充对于MTHFR 677TT型不明原因反复流产患者红细胞叶酸水平的影响

Impact of folic acid and active folate supplementation on red blood cell folate levels in patients with unexplained recurrent pregnancy loss and MTHFR 677TT genotype

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