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한국인 여성에서 임신 중 고혈압 질환의 발생과 apolipoprotein E 다형태의 관련성

Apolipoprotein E polymorphisms in the development of hypertensive diseases of pregnancy in Korean women

전종관|강지현|남화
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2008.07|Obstetrics & Gynecology Science|제51권 제7호|pp. 716-724

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키워드

임신Pregnancy고혈압HypertensionPolymorphismPreeclampsia자간전증아포지방단백질 E (Apo E)다형태Apolipoprotein E (Apo E)
주제분류산부인과학

초록

목적: 임신 중 고혈압은 산과적으로 가장 심각한 합병증 중 하나이지만 아직 그 원인이 알려져 있지 않다. 최근에 아포지방단백 질 E (apolipoprotein E, Apo E) 유전자에 다형태가 있으며 이것이 자간전증과 관련이 있다는 보고가 있다. 따라서 아포지방단 백질의 다형태 표지자가 임신 중 고혈압 발생과 관련이 있는지 알아보고자 하였다. 방법: 후향적연구를 수행하였으며, 120명의 건강한 산모와 임신 중 고혈압이 합병된 253명의 혈액에서 DNA를 추출하였다. 임신 중 고혈압군으로는 44명의 임신성고혈압 산모, 158명의 자간전증 산모 (경증 56명, 중증 102명), 30명의 복합성 자간증 산모 그리고 21명의 만성 고혈압 산모를 대상으로 하였다. 결과: 6개의 모든 유전자형을 확인할 수 있었지만 E2/2, E2/4, E4/4 유전자형은 매우 드물어 대립유전자형에 따른 분석을 실시 하였다. Apo ε2, ε3, ε4의 빈도는 다음과 같았다. 임신성고혈압의 경우 6.8%, 83.0%, 10.2%, 경증 자간전증은 4.5%, 84.8%, 10.7%, 중증 자간전증은 5.9%, 85.3%, 8.8%, 복합성 자간전증은 1.7%, 91.7%, 6.7%, 만성 고혈압은 0.0%, 90.5%, 9.5%, 대조군 은 5.2%, 86.5%, 8.5%였다. 각 군 간에 Apo E 대립유전자형에 따른 차이는 없었다 (P>0.05). 결론: Apo E의 대립유전자형은 한국인에서 임신 중 고혈압 질환의 위험인자로 생각되지 않는다.

Abstract

Objective: Hypertensive disorder in pregnancy is one of the most serious obstetrical complications. Apolipoprotein E (Apo E) genotype is polymorphic and recently it was reported to be associated with preeclampsia. We undertook this study to clarify whether polymorphic marker of apolipoprotein E is associated with the development of hypertensive disorder in pregnancy. Methods: Retrospective chart review was done. DNA was extracted from maternal blood of 124 healthy pregnant women and 253 women with hypertensive diseases in pregnancy. Hypertensive disorders complicating pregnancy include gestational hypertension (n=44), preeclampsia (n=158; mild=56, severe=102), preeclampsia superimposed preeclampsia (n=30), and chronic hypertension (n=21). Apo E allele was amplified by polymerase chain reaction, size fractionated on 4% agarose gels, and stained with ethidium bromide. Results: We found all six possible genotypes of Apo E. However, three genotypes, E2/2, E2/4 and E4/4, were uncommon in Korean. We analysed the data according to each allele. Allele frequencies of the Apo ε2, ε3 and ε4 were as follows: 6.8%, 83.0%, 10.2% in women with gestational hypertension, 4.5%, 84.8%, 10.7% in women with mild preeclampsia, 5.9%, 85.3%, 8.8% in women with severe preeclampsia, 1.7%, 91.7%, 6.7% in women with superimposed preeclampsia, 0.0%, 90.5%, 9.5% in women with chronic hypertension, and 5.2%, 86.5%, 8.5% in normal controls. No significant difference in Apo E alllele frequency was found among these groups (P>0.05). Conclusions: The study suggests that specific allele of apolipoprotein E does not appear to be a risk factor for hypertensive disorders complicating pregnancy in Korean population.

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