Associations Between The Maternal And Fetal AGT, ACE Gene Polymorphism And The Pregnancy Induced Hypertension In Chinese Han Women

Objective:1. To investigate the differences of demographic characteristics, family history, gestation information and Type A Behavior Pattern between cases and controls.2. To analyze the distribution of maternal and fetal AGT, ACE genotypes and alleles between cases and controls.3. To analyze the associations between the maternal and fetal AGT M235T and ACE I/D polymorphism and the susceptibility of pregnancy induced hypertension in Chinese Han women.Methods:1. This study was a case-control mother-baby dyads study. From January 2008 to December 2009, we recruited 113 pregnant women with a diagnosis of PIH and 113 controls from Maternal and Child Health Hospital in Anyang City. The information of demographic characteristics, family history, gestation information and Type A Behavior Pattern was collected by questionnaire surveys.2. Maternal and fetal blood samples were collected from study objects. ACE I/D polymorphism and AGT M235T polymorphism were detected by special PCR, PCR-RFLP and Agarose gel electrophoresis assays.3. The genotypes of AGT and ACE were divided into dominant model and recessive model, and then we examined the associations between the maternal and fetal AGT, ACE gene polymorphism and the susceptibility of PIH using conditional logistic regression. Results:1. Educational level, occupation, family residence, parity, gestational weeks, BMI before pregnancy, BMI before delivery, proportion of family history of hypertension and cardiovascular disease were found significant different between patients and controls (P<0.05). There were no significant differences of BMI change during pregnancy and family history of hypertension between cases and controls (P>0.05).2. In maternal AGT gene, the distribution of MM, MT, TT genotypes was 5.3%, 42.5%, 52.5% in cases, and 6.2%, 38.1%, 55.7% in controls (P>0.05). In maternal ACE gene, the distribution of II, ID, DD genotypes was 31.0%, 50.4%, 18.6% in cases, and 33.6%, 46.0%, 20.4% in controls (P>0.05).3. In fetal AGT gene, the distribution of MM, MT, TT genotypes was 5.3%, 53.1%, 41.6% in cases, and 8.8%,30.1%,61.1% in controls (P=0.002). In fetal ACE gene, the distribution of II, ID, DD genotypes was 25.7%, 60.2%, 14.1% in cases, and 26.5%, 59.3%, 14.2% in controls (P>0.05).4. In the result of conditional logistic regression analysis, it was shown that the mother with fetus carrying the TT genotype had a significant 0.52-fold decreased risk of PIH than the mother with fetus carrying the MT/MM genotype (95%CI=0.32-0.85) in the recessive model. After adjusting for maternal age, BMI before pregnancy, primiparity, maternal educational level, family history of hypertension and family history of cardiovascular disease, the odd ratio was 0.21 (95%=0.06-0.71). In the fetal ACE dominant model, it was shown that the mother with fetus carrying the ID/DD genotype had a significant 6.04-fold increased risk of PIH than the mother whose fetus carried the II genotype after adjusting for the other factors (95%CI=1.21-30.19).Conclusion:1. In current study, we found that obesity, low economic status, having family history of hypertension, having family history of cardiovascular disease and type A behavior pattern were associated with the susceptibility of pregnancy induced hypertension.2. The results regarding the distribution of maternal AGT, ACE gene alleles were similar with the previous studies in China, but were different with the studies conducted in other populations, showing different genetic background in different population.3. We didn't find an association between the maternal AGT gene M235T polymorphism, ACE gene I/D polymorphism and PIH. AGT gene TT genotype carried by fetus was one of the protective factors of maternal PIH. ACE gene D allele carried by fetus was one of the risk factor of maternal PIH.