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Habituel Abortus Olan Gebelerde Homosistein Folik Asid ve Vit B12 Seviyelerinin Değerlendirilmesi

Yıl 2021, Cilt: 16 Sayı: 3, 417 - 420, 01.11.2021
https://doi.org/10.17517/ksutfd.895874

Öz

Tekrarlayan gebelik kaybı iki veya daha fazla başarısız klinik gebelik veya intrauterin olması gerekmeyen ardışık üç gebelik kaybı olarak tanımlanır(3). Tekrarlayan gebelik kayıplarında homosistein düzeylerinin arttığını yada değişmediğini gösteren çalışmalar mevcuttur. Bu çalışmada, tekrarlayan gebelik kayıplarında serbest radikal benzeri etki gösteren homosistein ve homosisitein’in atılımında önemli fonksiyonlara sahip olan B12 ve folik asit düzeylerinde değişim olup olmadığı amaçlandı.

Gereç ve Yöntem: Bu çalışma, Kahramanmaraş Necip Fazıl Şehir Hastanesi Kadın Doğum ve Çocuk Hastalıkları ek binasında, retrospektif olarak ocak ve aralık 2020 tarihleri arasında 1. trimester tekrarlayan gebelik kaybı nedeniyle başvuran, 30 tekrarlayan gebelik kaybı olan hasta (Grup I) ve 1. trimesterde bulunan herhangi bir şikayeti olmayan 30 sağlıklı gebede (Grup II) plazma homosistein, serum folik asit ve vitamin B12 düzeyleri değerlendirildi.

Bulgular: Homosistein düzeyleri (µmol/L), Grup I: 17,6 ± 9,5, Grup II: 11,8 ± 4,6, Vitamin B12 düzeyleri (ng/L): Grup I: 233,4 ± 69,5, Grup II: 262,4 ± 76,7, folik asit düzeyleri (µg/L): Grup I: 7,7 ± 3,3, Grup II: 11,3 ± 3,7 olarak saptandı. Homosistein düzeylerinde; tekrarlayan gebelik kaybı olan grupta (Grup I) istatistiksel olarak anlamlı yükseklik saptandı (p<0.05). Folik asit düzeylerinde; tekrarlayan gebelik kaybı olan grupta (Grup I) istatistiksel olarak anlamlı düşüklük bulundu (p<0.05). Vitamin B12 düzeylerinde gruplar arasında istatistiksel olarak anlamlı bir fark görülmedi (p=.0.186). Yaşlar arasında istatistiksel olarak anlamlı bir fark saptanmadı (p=0.210).
Sonuç: Tekrarlayan gebelik kaybı olan hastalarda, homosistein, vitamin B12, folik asit düzeylerinin ethiolojide önemli bir etken olduğunu düşünmekteyiz

Kaynakça

  • 1.American College of Obstetricans and Gynecologists. Management of recurrent early pregnancy loss. ACOG Practice Bulletin 2001;24:1–8.
  • 2. Hee Young Cho, Han Sung Park , Eun Ju Ko, Chang Soo Ryu, Jung Oh Kim, Young Ran, Eun Hee Ahn, Woo Sik, Nam Keun Kim. Association of Complement Factor D and H Polymorphisms with Recurrent Pregnancy LossInt J. Mol. Sci. 2020, 21-17.
  • 3. Fateme Aghajanzadeh, Sedighe Esmaeilzadeh, Zahra Basirat, Treza Mahouti, Fateme Nadi Heidari, Masoumeh Golsorkhtabaramiri. Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure JBRA Assisted Reproduction 2020;24(1):30-33.
  • 4. Avisek Majumder, Mahavir Singh, Akash George, Suresh Tyagi. Restoration of skeletal muscle homeostasis by hydrogen sulfide during hyperhomocysteinemia-mediated oxidative/ER stress condition Can J Physiol Pharmacol. 2019 June ; 97(6): 441–456.
  • 5. Ganguly P, Alam SF. Role of homocysteine in the development of cardiovascular disease Nutr J. 2015 Jan 10;14:6.
  • 6.Perna AF, Ingrosso D. Homocysteine and chronic kidney disease: an ongoing narrative. J Nephrol. 2019 Oct;32(5):673-675.
  • 7. Gaiday AN, Tussupkaliyev AB, Bermagambetova SK, Zhumagulova SS, Sarsembayeva LK, Dossimbetova MB, et al. Effect of homocysteine on pregnancy: a systematic review. Chem Biol Interact 2018;293:70–6.
  • 8. Foka ZJ, Lambropoulos AF. Factor V leiden and prothrombin G20210A mutations, but not methylenetetrahydrofolate reductase C677T, are associated with recurrent miscarriages.Hum Reprod, 2000;15:458–62.
  • 9. Romine MF, Rodionov DA, Maezato Y, Anderson LN, Nandhikonda P, Rodionova IA, et al. Elucidation of roles for vitamin B12 in regulation of folate, ubiquinone, and methionine metabolism. Proceedings of the National Academy of Sciences. 2017;114 (7).
  • 10. Kalem P, Benli AR, Koroglu M, Benli NC, Koyuncu M, Cesur O, et al. The effect of ferritin, vitamin B12 and folic acid on pregnancy outcomes. Int J Clin Exp Med. 2016;9(11):22413-7.
  • 11. Garcia-Casal M, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies infants, children, adolescents and pregnant women in Venezuela. European Journal of Clinical Nutrition. 2005;59(9):1064-70.
  • 12. de Jager J, Kooy A, Lehert P, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B12 deficiency: randomised placebo controlled trial. BMJ. 2010;340:c2181.
  • 13. Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine receptor antagonist use and vitamin B12 deficiency. JAMA. 2013;310(22):2435-2442.
  • 14. Curro M, Gugliandolo A, Gangemi C, Risitano R, Ientile R, Caccamo D. Toxic effects of mildly elevated homocysteine concentrations in neuronal-like cells. Neurochem Res. 2014;39:1485–95.
  • 15. Paul Ganguly, Sreyoshi Fatima Alam. Role of homocysteine in the development of cardiovascular disease. Ganguly and Alam Nutrition Journal 2015, 14:6.
  • 16. Yu M, Li W, Luo S, Zhang Y, Liu H, Gao Y, Wang X, Wilson J, Huang G. Folic acid stimulation of neural stem cell proliferation is associated with altered methylation profile of PI3K/Akt/CREB. J. Nutr. Biochem. 2014, 25, 496–502.
  • 17. Lo A, Polsek D, Sidhu S. Estimating the burden of neural tube defects in low- and middle in come countries. J Glob Health 2014;4(1):010402.
  • 18. Stirzaker C, Song, J.Z, Ng W, Du Q, Armstrong, N.J, Locke W.J Statham A.L, French H, Pidsley R. et al. Methyl-CpG-binding protein MBD2 plays a key role in maintenance and spread of DNA methylation at CpG islands and shores in cancer. Oncogen 2016.
  • 19. Jakubowski H. Homocysteine Modification in Protein Structure/Function and Human Disease. Physiol Rev 99: 555–604, 2019.
  • 20. Rai R, Regan L. Recurrent miscarriage. The Lancet 2006;368(9535):601–11. 21. Silver RM, Branch DW, Goldenberg R, Iams JD, Klebanoff MA. Nomenclature for pregnancy outcomes: time for a change. Obstet Gynecol 2011;118(6):1402–8.
  • 22. Karen J. Gibbins, T. Flint Porter. The Importance of an Evidence Based Workup for Recurrent Pregnancy Loss Clin Obstet Gynecol. 2016 September ; 59(3): 456–463.
  • 23. Boots C, Stephenson MD. Does obesity increase the risk of miscarriage in spontaneous conception: a systematic review. Semin Reprod Med 2011;29(6):507–13.
  • 24. Jakubowski H. Homocysteine editing, thioester chemistry, coenzyme A, and the origin of coded peptide synthesis. 2017 Life (Basel) 7: 6.
  • 25. Kilmer S McCully Homocysteine, Thioretinaco Ozonide, and Oxidative Phosphorylation in Cancer and Aging: A Proposed Clinical Trial Protocol Methods Mol Biol. 2019;1866:285-310.
  • 26. Mcdowell IFW, Long D. Homosisteine and endothelial dysfunction: A link with cardiovascular disease. J Nutr 2000;130:3695-725.
  • 27. Pullin CH, Wilson JF, Ashfield-Watt PAL, et al. Influence of methylenetetrahydrofolate reductase genotype, exercise and other risk factors on endothelial function in healthy individuals. Clin Sci 2002;102:45-50.
  • 28. Chambers J, Skooner J. Homosisteine: A novel risk factor for coronery heart disease in UK Indian Asians. Heart 2001;86:121-2.
  • 29. Nelen WL, Bulten J, Steegers EA, Blom HJ, Hanselaar AG, Eskes TK. Maternal homocysteine and chorionic vascularization in recurrent early pregnancy loss. Hum Reprod 2000;15:954–60.
  • 30.Danielius Serapinas , Evelina Boreikaite , Agne Bartkeviciute , Rita Bandzeviciene , Mindaugas Silkunas , Daiva Bartkeviciene. 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 2017 Sep;72:159-163.
  • 31. Sikora J, Magnucki J, Zietek J, Kobielska L, Partyka R, Kokocinska D, et al. Homocysteine, folic acid and vitamin B12 concentration in patients with recurrent miscarriages. Neuro Endocrinol Lett 2007;28:507–12.
  • 32. Wouters MG, Boers GH, Blom HJ, Trijbels FJ, Thomas CM, Borm GF, et al. Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss. Fertil Steril 1993;60:820–5.
  • 33. Sathnur Pushpakumar, Sourav Kundu, Utpal SenEndothelial Dysfunction: The Link Between Homocysteine and Hydrogen SulfideCurr Med Chem. 2014 ; 21(32): 3662–3672.

HOMOCYSTEIN PHOLIC ACID AND VIT B12 LEVELS IN RECURRENT PREGNANCY LOSSES

Yıl 2021, Cilt: 16 Sayı: 3, 417 - 420, 01.11.2021
https://doi.org/10.17517/ksutfd.895874

Öz

HOMOCYSTEIN PHOLIC ACID AND VIT B12 LEVELS IN RECURRENT PREGNANCY LOSSES
Summary;
Recurrent pregnancy loss is defined as two or more unsuccessful clinical pregnancies or three consecutive pregnancies that are not necessarily intrauterine (3). There are studies showing that homocysteine levels increase or do not change in recurrent pregnancy losses. In this study, it was aimed whether there was a change in B12 and folic acid levels, which have important functions in the excretion of free radical-like homocysteine and homocysteine in recurrent pregnancy losses.

Materials and Methods: This study included 30 patients with recurrent pregnancy loss (Group I) and 1. Plasma homocysteine, serum folic acid and vitamin B12 levels were evaluated in 30 healthy pregnant women (Group II) in the trimester without any complaints.

Results: Homocysteine levels (µmol / L), Group I: 17.6 ± 9.5, Group II: 11.8 ± 4.6, Vitamin B12 levels (ng / L): Group I: 233.4 ± 69, 5, Group II: 262.4 ± 76.7, folic acid levels (µg / L): Group I: 7.7 ± 3.3, Group II: 11.3 ± 3.7. At homocysteine levels; A statistically significant increase was found in the group with recurrent pregnancy loss (Group I) (p <0.05). At folic acid levels; A statistically significant decrease was found in the group with recurrent pregnancy loss (Group I) (p <0.05). There was no statistically significant difference in vitamin B12 levels between the groups (p = .0.186). There was no statistically significant difference between ages (p = 0.210).
Conclusion: We think that homocysteine, vitamin B12 and folic acid levels are important factors in ethiology in patients with recurrent pregnancy loss.

Kaynakça

  • 1.American College of Obstetricans and Gynecologists. Management of recurrent early pregnancy loss. ACOG Practice Bulletin 2001;24:1–8.
  • 2. Hee Young Cho, Han Sung Park , Eun Ju Ko, Chang Soo Ryu, Jung Oh Kim, Young Ran, Eun Hee Ahn, Woo Sik, Nam Keun Kim. Association of Complement Factor D and H Polymorphisms with Recurrent Pregnancy LossInt J. Mol. Sci. 2020, 21-17.
  • 3. Fateme Aghajanzadeh, Sedighe Esmaeilzadeh, Zahra Basirat, Treza Mahouti, Fateme Nadi Heidari, Masoumeh Golsorkhtabaramiri. Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure JBRA Assisted Reproduction 2020;24(1):30-33.
  • 4. Avisek Majumder, Mahavir Singh, Akash George, Suresh Tyagi. Restoration of skeletal muscle homeostasis by hydrogen sulfide during hyperhomocysteinemia-mediated oxidative/ER stress condition Can J Physiol Pharmacol. 2019 June ; 97(6): 441–456.
  • 5. Ganguly P, Alam SF. Role of homocysteine in the development of cardiovascular disease Nutr J. 2015 Jan 10;14:6.
  • 6.Perna AF, Ingrosso D. Homocysteine and chronic kidney disease: an ongoing narrative. J Nephrol. 2019 Oct;32(5):673-675.
  • 7. Gaiday AN, Tussupkaliyev AB, Bermagambetova SK, Zhumagulova SS, Sarsembayeva LK, Dossimbetova MB, et al. Effect of homocysteine on pregnancy: a systematic review. Chem Biol Interact 2018;293:70–6.
  • 8. Foka ZJ, Lambropoulos AF. Factor V leiden and prothrombin G20210A mutations, but not methylenetetrahydrofolate reductase C677T, are associated with recurrent miscarriages.Hum Reprod, 2000;15:458–62.
  • 9. Romine MF, Rodionov DA, Maezato Y, Anderson LN, Nandhikonda P, Rodionova IA, et al. Elucidation of roles for vitamin B12 in regulation of folate, ubiquinone, and methionine metabolism. Proceedings of the National Academy of Sciences. 2017;114 (7).
  • 10. Kalem P, Benli AR, Koroglu M, Benli NC, Koyuncu M, Cesur O, et al. The effect of ferritin, vitamin B12 and folic acid on pregnancy outcomes. Int J Clin Exp Med. 2016;9(11):22413-7.
  • 11. Garcia-Casal M, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies infants, children, adolescents and pregnant women in Venezuela. European Journal of Clinical Nutrition. 2005;59(9):1064-70.
  • 12. de Jager J, Kooy A, Lehert P, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B12 deficiency: randomised placebo controlled trial. BMJ. 2010;340:c2181.
  • 13. Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine receptor antagonist use and vitamin B12 deficiency. JAMA. 2013;310(22):2435-2442.
  • 14. Curro M, Gugliandolo A, Gangemi C, Risitano R, Ientile R, Caccamo D. Toxic effects of mildly elevated homocysteine concentrations in neuronal-like cells. Neurochem Res. 2014;39:1485–95.
  • 15. Paul Ganguly, Sreyoshi Fatima Alam. Role of homocysteine in the development of cardiovascular disease. Ganguly and Alam Nutrition Journal 2015, 14:6.
  • 16. Yu M, Li W, Luo S, Zhang Y, Liu H, Gao Y, Wang X, Wilson J, Huang G. Folic acid stimulation of neural stem cell proliferation is associated with altered methylation profile of PI3K/Akt/CREB. J. Nutr. Biochem. 2014, 25, 496–502.
  • 17. Lo A, Polsek D, Sidhu S. Estimating the burden of neural tube defects in low- and middle in come countries. J Glob Health 2014;4(1):010402.
  • 18. Stirzaker C, Song, J.Z, Ng W, Du Q, Armstrong, N.J, Locke W.J Statham A.L, French H, Pidsley R. et al. Methyl-CpG-binding protein MBD2 plays a key role in maintenance and spread of DNA methylation at CpG islands and shores in cancer. Oncogen 2016.
  • 19. Jakubowski H. Homocysteine Modification in Protein Structure/Function and Human Disease. Physiol Rev 99: 555–604, 2019.
  • 20. Rai R, Regan L. Recurrent miscarriage. The Lancet 2006;368(9535):601–11. 21. Silver RM, Branch DW, Goldenberg R, Iams JD, Klebanoff MA. Nomenclature for pregnancy outcomes: time for a change. Obstet Gynecol 2011;118(6):1402–8.
  • 22. Karen J. Gibbins, T. Flint Porter. The Importance of an Evidence Based Workup for Recurrent Pregnancy Loss Clin Obstet Gynecol. 2016 September ; 59(3): 456–463.
  • 23. Boots C, Stephenson MD. Does obesity increase the risk of miscarriage in spontaneous conception: a systematic review. Semin Reprod Med 2011;29(6):507–13.
  • 24. Jakubowski H. Homocysteine editing, thioester chemistry, coenzyme A, and the origin of coded peptide synthesis. 2017 Life (Basel) 7: 6.
  • 25. Kilmer S McCully Homocysteine, Thioretinaco Ozonide, and Oxidative Phosphorylation in Cancer and Aging: A Proposed Clinical Trial Protocol Methods Mol Biol. 2019;1866:285-310.
  • 26. Mcdowell IFW, Long D. Homosisteine and endothelial dysfunction: A link with cardiovascular disease. J Nutr 2000;130:3695-725.
  • 27. Pullin CH, Wilson JF, Ashfield-Watt PAL, et al. Influence of methylenetetrahydrofolate reductase genotype, exercise and other risk factors on endothelial function in healthy individuals. Clin Sci 2002;102:45-50.
  • 28. Chambers J, Skooner J. Homosisteine: A novel risk factor for coronery heart disease in UK Indian Asians. Heart 2001;86:121-2.
  • 29. Nelen WL, Bulten J, Steegers EA, Blom HJ, Hanselaar AG, Eskes TK. Maternal homocysteine and chorionic vascularization in recurrent early pregnancy loss. Hum Reprod 2000;15:954–60.
  • 30.Danielius Serapinas , Evelina Boreikaite , Agne Bartkeviciute , Rita Bandzeviciene , Mindaugas Silkunas , Daiva Bartkeviciene. 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 2017 Sep;72:159-163.
  • 31. Sikora J, Magnucki J, Zietek J, Kobielska L, Partyka R, Kokocinska D, et al. Homocysteine, folic acid and vitamin B12 concentration in patients with recurrent miscarriages. Neuro Endocrinol Lett 2007;28:507–12.
  • 32. Wouters MG, Boers GH, Blom HJ, Trijbels FJ, Thomas CM, Borm GF, et al. Hyperhomocysteinemia: a risk factor in women with unexplained recurrent early pregnancy loss. Fertil Steril 1993;60:820–5.
  • 33. Sathnur Pushpakumar, Sourav Kundu, Utpal SenEndothelial Dysfunction: The Link Between Homocysteine and Hydrogen SulfideCurr Med Chem. 2014 ; 21(32): 3662–3672.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Gürkan Çıkım 0000-0002-7572-3962

Abdullah Tok 0000-0003-0998-5531

Yayımlanma Tarihi 1 Kasım 2021
Gönderilme Tarihi 12 Mart 2021
Kabul Tarihi 11 Ağustos 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 16 Sayı: 3

Kaynak Göster

AMA Çıkım G, Tok A. Habituel Abortus Olan Gebelerde Homosistein Folik Asid ve Vit B12 Seviyelerinin Değerlendirilmesi. KSÜ Tıp Fak Der. Kasım 2021;16(3):417-420. doi:10.17517/ksutfd.895874