The musculoskeletal system diseases in pregnant women with high infection risk and the single nucleotide rs1544410 polymorphism of the calcitriol receptor gene

Abstract

Background. The problem of vitamin D (VD) deficiency in the population, in general, and in pregnant women, in particular, and related diseases, including the musculoskeletal system, remains one of the most widespread medical and social problems of our time. The purpose was to determine the frequency of musculoskeletal diseases in pregnant females at high infection risk (HIR) with impaired vitamin D status and single-nucleotide Bsml polymorphism of its receptor gene. Materials and methods. Fifty-six pregnant women (main group) with HIR and 40 healthy pregnant women (control group) had been examined. The level of 25-hydroxyvitamin D (25(OH)D) in blood was determined by the enzyme-linked immunosorbent assay, and real-time polymerase chain reaction was used to detect the mutant version of Bsml (rs1544410) polymorphism of the gene that is encoding vitamin D receptors (VDR). Statistical processing of the results was done using the resource www.socscistatistics.com. Results. HIR was due to the presence of chronic kidney diseases, carriers of pathogens of the TORCH group of infections and conditionally pathogenic microflora in the urogenital tract. The level of 25(OH)D was lower than the generally accepted optimal level in 76.8 and 15 % of pregnant women, in the main and control groups, respectively (F = 0.03; p = 0.0001). Carriers of the heterozygous genotype A/G were 67.7 % of pregnant women with HIR compared to 35 % of the control group (odd ratio (OR) = 3.95; 95% confidence interval (CI): 2.19–7.1; χ2 = 20.88, p = 0.00001), and the G/G genotype was inherent in 19.6 and 47.5 % of women, respectively (OR = 0.27; 95% CI 0.15–0.51;  p = 0.00006). A third of pregnant women from the main group had a history of musculoskeletal diseases (32.14 %) versus 12.5 % in control group (OR = 3.15; 95% CI: 1.54–6.46); 71.4 % of pregnant women with HIR were carriers of A/G genotype (OR = 9.79; 95% CI: 5.10–18.82). Conclusions. The share of vitamin D deficiency/insufficiency in pregnant women with HIR is almost 77 %. The general somatic history of these women is characterized by a high frequency of the kidney diseases (37.5 %) and musculoskeletal diseases (32.1 %). Two-thirds of pregnant women with HIR, as well as with musculoskeletal diseases, are carriers of the heterozygous Bsml of polymorphic genotype A/G of the VDR gene, which probably causes a higher risk of the development of pathology in conditions of calcitriol deficiency. Studying VD status, the genetic personification of disease risks, and correction of modified factors in time, in particular, VD deficiency is seen as a promising direction for improving perinatal outcomes and the quality of life of pregnant women in general, but further research is required.