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Sep 27, 2019

13th European Nutrition Conference, FENS 2019| Malnutrition in an Obese World:European Perspectives

P4-01-05 - Investigation of Blood Pressure during the First Trimester of Pregnancy in relation to the MTHFR C677T Polymorphism

blood pressure

hypertension in pregnancy

one-carbon metabolism

mthfr

riboflavin

single nucleotide polymorphism

gene-nutrient interaction

pregnancy

Abstract

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Abstract

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Keywords

blood pressure

hypertension in pregnancy

one-carbon metabolism

mthfr

riboflavin

single nucleotide polymorphism

gene-nutrient interaction

pregnancy

Abstract

Hypertension affects 10-15% of all pregnancies and can lead to serious hypertensive disorders which are the major causes of fetal and maternal morbidity and mortality worldwide. Disturbances in one-carbon metabolism may be associated with hypertensive disorders of pregnancy, albeit the evidence is somewhat conflicting. Consistent evidence however links the common MTHFR C677T polymorphism in the gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase with an increased risk of hypertension in pregnancy. Furthermore, randomised controlled trials (RCTs) conducted in hypertensive patients showed that riboflavin (the MTHFR co-factor) lowered BP specifically in those with the variant MTHFR 677TT genotype, but neither the role of this folate polymorphism nor its interaction with riboflavin during pregnancy has been previously investigated. The aim was to investigate the impact of MTHFR genotype and riboflavin status on BP in the first trimester of pregnancy. As part of the Optimal Nutrition for the Prevention of Hypertension (OptiPREG) study, pregnant women were recruited from antenatal clinics in Northern Ireland and the Republic of Ireland and screened for MTHFR genotype. Biomarker status of riboflavin was determined using the functional assay erythrocyte glutathione reductase activation coefficient (EGRac). Of 1709 participants recruited and screened, 11.5% were identified with the variant MTHFR genotype. Within the first trimester, an atypical pattern of BP was observed in these women, in that both systolic and diastolic BP increased from the 8th to 16th gestational week (GW), compared with the expected decrease in BP over this time, as previously reported and found here in women without this polymorphism (CC/CT genotypes combined). At the 12th GW, after adjusting for maternal and gestational age, women with the TT genotype compared to CC or CT genotypes had significantly higher systolic BP (P 0.026), diastolic BP (P 0.050) and hypertension rate (10.4 vs 4.0 or 5.4%; P 0.048). When these results were stratified by riboflavin, the BP phenotype owing to this polymorphism was exacerbated among women with suboptimal status (i.e. EGRac>1.26), with median (95% CI) systolic BP of 118.5 (114.6, 121.5) mmHg compared to 114.5 (111.7, 119.2) mmHg in those with optimal status (EGRac≤1.26) within the TT genotype group. In conclusion, the TT genotype is associated with higher BP during the first trimester of pregnancy and riboflavin may have an important modulating effect on BP in these women. An RCT is currently ongoing at Ulster to fully investigate the role of MTHFR genotype and its interaction with riboflavin on BP during pregnancy.

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© Copyright 2019 Morressier GmbH.
All rights reserved.