조기양막파열 산모에서 matrix metalloproteinase-1과 -2 유전자 다형성
Polymorphisms of matrix metalloproteinase-1 and -2 genes in the pregnant women with preterm premature rupture of membranes
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목적: 조기양막파열에 의한 조기분만이 기질 금속단백분해효소 (matrix metalloproteinase; MMP)-1과 -2 유전자 다형성과 연관성이 있는지 알아보기 위해 이 연구를 시행하였다. 연구 방법: 본 연구는 본원에서 분만한 한국인 임산부를 대상으로 하였다. 연구군으로는 조기양막파열로 임신 37주 이전에 분만한 31예, 대조군으로는 조기분만의 과거력이 없으면서 임신 37주 이후에 분만한 291예를 대상으로 검체를 얻었다. DNA를 임산부의 혈액으로부터 추출하여 MMP-1 promotor -1607과 MMP-2 promotor -1306의 유전자형을 알기 위하여 중합효소연쇄반응과 직접 염기순서분석을 시행하였다. 결과: MMP-1*1G의 유전자형 보인율은 조기양막파열군이 정상임신군에 비해 유의하게 높았다 (p=0.020; 교차비 3.09, 95% 신뢰구간 1.14-8.35). 또한 MMP-1*1G 대립유전자의 빈도도 조기양막파열군이 정상임신군에 비해 유의하게 높았다 (p=0.011, 교차비 1.97, 95% 신뢰구간 1.16-3.36). 그러나 MMP-2의 경우에는 유전자형 보인율과 대립유전자형의 빈도가 모두 두 군간에 유의한 차이가 없었다 (p=0.430, 교차비 1.48, 95% 신뢰구간 0.56-3.96; p=0.377, 교차비 1.58, 95% 신뢰구간 0.57-4.40). 결론: MMP-1 promotor -1607 유전자 다형성은 한국인 임산부에서 조기양막파열과 연관성이 있을 것으로 사료된다.
Abstract
Objective: To elucidate whether polymorphisms of matrix metalloproteinase (MMP)-1 and -2 promotor genes are associated with preterm delivery caused by preterm premature rupture of membranes (PPROM) in Korean pregnant women. Methods : We conducted a case-control study of korean pregnant women admitted to our labor and delivery unit. PPROM group (n=31) was defined as women whom delivered before 37 weeks of gestation due to PPROM. Control group (n=291) included women who were delivered after 37 weeks of gestation and had no history of preterm delivery. Genomic DNA was extracted from maternal peripheral blood. Polymerase chain reaction (PCR) and direct sequencing were done to determine the genotype of MMP-1 promotor -1607 and MMP-2 promotor -1306 of each participant. Data was analyzed by 2-tailed unpaired t test, χ2 test, odds ratio with 95% confidence interval (CI) using SPSS 10.0. Results: The carrier rate of MMP-1*1G was significantly higher in the PPROM group than that in the control group (p=0.020; odds ratio 3.09, 95% CIl 1.14-8.35). The frequency of 1G allele of MMP-1 was also significantly higher in the PPROM group than that in the control group (p=0.011, odds ratio 1.97, 95% CI 1.16-3.36). There was, however, no significant difference in the carrier rate of genotype as well as in the allelic frequencies of MMP-2*T in PPROM group compared with the control group (p=0.430, odds ratio 1.48, 95% CIl 0.56-3.96; p=0.377, odds ratio 1.58, 95% CI 0.57-4.40). Conclusion: Our data suggest that polymorphism of MMP-1 promotor -1607 might be associated with PPROM in Korean pregnant women.
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