The assessment of the efficiency of 5-methyltethydrofolate according to level by homocysteine, methionine and betaine in pregnant women with polymorphism rs 1801133 (677 C> T) of the MTHFR gene


  • O. B. Lastovetska
  • O. V. Bulavenko
Keywords: rs1801133 (677 C>T) polymorphism of the MTHFR gene, women of late reproductive age, embryonic losses, 5-methyltetrahydrofolate, betaine, homocysteine, methionine.

Abstract

Annotation. The prevention of early pregnancy loss, taking into account the polymorphism of the genes of enzymes that controlling folate metabolism, have become the goal of clinical studies in recent years, and the determination of risk factors for patients of late reproductive age and embryonic losses in history becomes critical for the development of effective measures to prevent miscarriage. The use of medical prevention of perinatal pathology using a biologically active form of folate in the form of 5-methyltetrahydrofolate in women with anamnestic loss of pregnancy looks promising. The aim of the study was to evaluate the effectiveness of drug prevention in patients with anamnestic embryonic losses, taking into account the role of the rs1801133 (677 C>T) polymorphism of the MTHFR gene based on the results of the dynamics of serum levels of homocysteine, betaine, and methionine. The patients were divided into the main group (polymorphism rs1801133 (677 C>T) of the MTHFR gene and anamnestic embryonic loss), which was divided into 2 subgroups: I subgroup included 20 women who received folic acid preparations (400 μg per day), II subgroup – 20 patients who received a complex preparation containing 5-methyltetrahydrofolate and control groups (practically healthy women) (n=20). Prescribing drugs began at the pre-gravid stage 8–10 weeks before pregnancy planning, and the administration ended up to 26 weeks of pregnancy. Determination of serum homocysteine levels and markers of folate metabolism - methionine and betaine – were performed at the end of the 1st – beginning of the 2nd trimester of pregnancy and in the third trimester. In the study of the effectiveness of preventive therapy on the dynamics of markers of folate metabolism functionality in pregnant women of late reproductive age with anamnestic embryonic losses and polymorphism rs1801133 (677 C>T) of the MTHFR gene when using a combined drug containing folic acid and 5-methyltetrahydrofolate, at the first end – at the beginning In the second trimester, there was a significant increase in betaine and methionine (p<0.05), while in the third trimester, a positive statistically significant difference (p<0.05) was diagnosed in an increase in methionine, betaine and a decrease in serum homocysteine levels.

References

1. Arkhipkina, T. L., & Lyubimova, L. P. (2016). Gipergomotsisteinemiya, disfunktsiya endoteliya i ikh svyazi s polovymi steroidami pri sindrome polikistoznykh yaichnikov [Hyperhomocysteinemia, endothelial dysfunction and their relation to sex steroids in polycystic ovary syndrome]. Akusherstvo, ginekologiya i reproduktsiya – Obstetrics, Gynecology and Reproduction, 10 (3), 24–28. doi.org/10.17749/2313-7347.2016.10.2.024-028

2. Bitsadze, V. O., Samburova, N. V., Makatsariya, N. A., & Mishchenko, A. L. (2016). Folatdefitsitnye sostoyaniya v akusherskoy praktike i problema ikh korrektsii [Folate deficiency states in obstetric practice and the problem of their correction]. Akusherstvo, ginekologiya i reproduktsiya – Obstetrics, gynecology and reproduction, 10 (1), 38–48. doi.org/10.17749/2313-7347.2015.10.1.038-048.

3. Gromova, O. A., Torshin, I. Yu., Tetruashvili, N. K., & Limanova, O. A. (2018). O novykh tendentsiyakh v nutritsialnoy podderzhke beremennosti [On new trends in nutritional support for pregnancy]. Akusherstvo i ginekologiya – Obstetrics and Gynecology, 1, 21–28. doi.org/10.18565/aig.2018.1.21-28

4. Zhabchenko, I. A. (2019). Suchasnyi pohliad na rol folativ u profilaktytsi perynatalnykh problem [Modern view on the role of folate in the prevention of perinatal problems]. Reproduktyvna endokrynolohiia – Reproductive endocrinology, 2 (46), 57–61. doi.org/10.18370/2309-4117.2018.46.57-61

5. Konkov, D. H., Klyvak, V. V., Taran, O. A., & Lastovetska, O. B. (2020). Cuchasni klinichni aspekty efektyvnoi profilaktyky hestatsiinoi ta fetalnoi patolohii [Modern clinical aspects of effective prevention of gestational and fetal pathology]. Reproduktyvna endokrynolohiia – Reproductive Endocrinology, 3 (53), 55–60. doi.org/10.18370/2309-4117.2020.53.55-60

6. Konkov, D. H., Bulavenko, O. V., Dudnyk, V. M., & Buran, V. V. (2016). Suchasni aspekty patohenetychno obumovlenoi profilaktyky preeklampsii [Modern aspects of pathogenetically determined prevention of preeclampsia]. Perinatologiya i pediatriya – Perinatology and Pediatrics, 1, 46–50. doi 10.15574/PP.2016.65.46

7. Lastovetska, O. B., Bulavenko, O. V., Konkov, D. H., & Buran, V. V. (2020). Efektyvnist profilaktychnoho zastosuvannia foliievoi kysloty i kompleksu z aktyvnymy folatamy v zhinok iz henetychnym polimorfizmom MTHFRC677T ta embrionalnymy vtratamy v anamnezi [Efficacy of prophylactic use of folic acid and complex with active folate in women with genetic polymorphism MTHFRC677T and a history of embryonic loss]. Reproduktyvna endokrynolohiia – Reproductive Endocrinology, 3 (53), 55–60. doi.org/10.18370/2309-4117.2020.53.55-60

8. Berbets, A. M., Barbe, A. M., Andriiets, O. A., Andriiets, A. V., & Yuzko, O. M. (2020). Melatonin levels decrease in the umbilical cord in case of intrauterine growth restriction. Journal of medicine and life, 13(4), 548–553. https://doi.org/10.25122/jml-2020-0128

9. Dimitriadis, E., Menkhorst, E., Saito, S., Kutteh, W. H., & Brosens, J. J. (2020). Recurrent pregnancy loss. Nat. Rev. Dis. Primers., 6 (1), 98. doi.org/10.1038/s41572-020-00228-z

10. American College of Obstetricians and Gynecologists (2018). ACOG Practice Bulletin No. 200: Early pregnancy loss. Obstet. Gynecol., 132, e197–207. doi: 10.1097/AOG.0000000000002899

11. Dodds, L., Fell, D. B., Dooley, K. C., Armson, B. A., Allen, A. C., Nassar, B. A., … & Joseph, K. S. (2008). Effect of homocysteine concentration in early pregnancy on gestational hypertensive disorders and other pregnancy outcomes. Clinical Chemistry, 54 (2), 326–334. doi.org/10.1373/clinchem.2007.097469

12. El Hachem, H., Crepaux, V., May-Panloup, P., Descamps, P., Legendre, G., & Bouet, P. E. (2017). Recurrent pregnancy loss: current perspectives. Int. J. Womens Health, 9, 331–345. doi: 10.2147/IJWH.S100817

13. Ignaszak-Kaus, N., Ozegowska, K., Piekarski, P., Pawelczyk, L., & Jędrzejczak, P. (2018). Planning and preparation for pregnancy among women with and without a history of infertility. Ginekol. Pol., 89 (2), 74–79. doi: 10.5603/GP.a2018.0013

14. Naert MN, Khadraoui H, Muniz Rodriguez A, Naqvi M, Fox NS. (2019). Association between first-trimester subchorionic hematomas and pregnancy loss in singleton pregnancies. Obstet Gynecol., 134(2), 276-281. doi: 10.1097/AOG.0000000000003360

15. Raghavan, R., Dreibelbis, C., Kingshipp, B. L., Wong, Y. P., Abrams, B., Gernand, A. D. … & Stoody, E. E. (2019). Dietary patterns before and during pregnancy and birth outcomes: a systematic review. Am. J. Clin. Nutr., 109 (7), 729S–756S. doi: 10.1093/ajcn/nqy353

16. Rasmark, R. E., Hellgren, M., Hjertberg, R., Blomqvist, L., Matthiesen, L., Strandell, A. (2018). Treatment efficacy for idiopathic recurrent pregnancy loss – a systematic review and meta-analyses. Acta Obstet. Gynecol. Scand., 97 (8), 921–941. doi: 10.1111/aogs.13352

17. Serapinas, D., Boreikaite, E., Bartkeviciute, A., Bandzeviciene, R., Silkunas, M., & Bartkeviciene, D. (2017). The importance of folate, vitamins B6 and B12 for the lowering of homocysteine concentrations for patients with recurrent pregnancy loss and MTHFR mutations. Reprod. Toxicol., 72, 159–163. doi: 10.1016/j.reprotox.2017.07.001
Published
2020-12-28
How to Cite
Lastovetska, O. B., & Bulavenko, O. V. (2020). The assessment of the efficiency of 5-methyltethydrofolate according to level by homocysteine, methionine and betaine in pregnant women with polymorphism rs 1801133 (677 C&gt; T) of the MTHFR gene. Reports of Vinnytsia National Medical University, 24(4), 618-623. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2020-24(4)-10