Assessment of Metalloproteinase Matrix 9 (MMP9) Gene Polymorphisms Risk Factors for Pelvic Organ Prolapse in the Brazilian Population

Abstract

Objective To evaluate the C-1562T matrix metalloproteinase 9 (MMP9) gene polymorphisms as risk factors related to the occurrence of pelvic organ prolapse (POP) and to identify the clinical variables associated with the occurrence of the disease. Epidemiological studies of risk factors for POP do not explain why nulliparous women with no known risk factors also develop POP. Therefore, genetic factors may be involved.

Methods Cohort study with 86 women with symptomatic POP (cases), and 158 women without a prior or current diagnosis of this disorder (controls). The groups were analyzed for the presence of MMP9 gene polymorphisms. Genotyping was performed using polymerase chain reaction (PCR) with DNA obtained from a peripheral venous puncture of both groups.

Results There were no differences between the cases and controls even when we grouped the mutant homozygous and heterozygous genotypes. The analysis of patients with a complete absence of POP versus patients with total POP also showed no statistically significant differences. Age and home birth were found to be independent risk factors for POP.

Conclusions There were no statistically significant differences in the C-1562T MMP9 polymorphisms between the cases and controls in Brazilian women.

Resumo

Objetivo Avaliar polimorfismos do gene C-1562T do gene matriz de metaloproteinase 9 (MMP9) como fatores de risco relacionados à ocorrência de prolapso de órgão pélvico (POP) e identificar variáveis clínicas associadas à ocorrência da doença. Estudos epidemiológicos de fatores de risco para POP não explicam por que mulheres nulíparas sem fatores de risco conhecidos também desenvolvem POP. Portanto, fatores genéticos podem estar envolvidos.

Métodos Estudo de coorte com 86 mulheres com POP sintomático (casos) e 158 mulheres sem diagnóstico prévio ou atual deste transtorno (controles). Os grupos foram analisados quanto à presença de polimorfismo do gene MMP9. A genotipagem foi realizada por reação em cadeia da polimerase (RCP) com DNA obtido por punção venosa periférica dos indivíduos em ambos os grupos.

Resultados Não houve diferenças entre os casos e controles, mesmo quando agrupamos os genótipos mutantes homozigotos e heterozigotos. A análise de pacientes com ausência completa de POP versus pacientes com POP total também não mostrou diferenças estatisticamente significativas. Idade e parto domiciliar foram considerados fatores de risco independentes para o POP.

Conclusão Não houve diferenças estatisticamente significativas no polimorfismo C-1562T do gene MMP9 entre os casos e controles em mulheres brasileiras.

Keywords

polymorphism - matrix metalloproteinase - pelvic organ prolapse

Palavras-chave

polimorfismo - matriz de metaloproteinase - prolapso de órgão pélvico

Contributors

All of the authors contributed to the conception and design of the present study, to the data collection or to the analysis and interpretation of data, as well as to the writing of the article or to the critical review of the intellectual content and to the final approval of the version to be published.

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