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Abstract Objective: To investigate the relationship of plasma homocysteine (Hcy) levels and inflammatory reaction for women with missed abortion, and to explore its potential pathological mechanism. Methods: From December 2015 to August 2016, 205 women came to Zhangjiagang hospital affiliated to Nanjing Chinese traditional medical university for curettage were selected as objects, which including 72 cases with missed abortion in study group, and another 133 cases with unwanted artificial abortion in control group. The levels of plasma Hcy and folate acid, and mRNA expression levels of inflammatory cytokines such as Toll like receptor 2 (TLR2), Toll like receptor 4 (TLR4), tumor necrosis factor α (TNFα) were tested and compared between the two groups. The effects of plasma Hcy, folic acid and inflammatory factors on missed abortion were analyzed, and level of plasma Hcy correlation to folic acid and inflammatory factors was also analyzed. Results: The level of plasma Hcy of women in study group was significantly higher than that of women in control group (P<0.01), while the average level of folic acid of women in study group was significantly lower than that of women in control group (P<0.01). The expression level of TNFα, TLR2 and TLR4 mRNA of women in study group were significantly different from those of women in control group (P<0.05). And the level of plasma Hcy was positively correlated with the levels of inflammatory factors, such as TNFα, TLR2 and TLR4 (r=086, P<0.01; r=0.78, P<0.05; r=0.75, P<0.05), and plasma Hcy was negatively correlated with folic acid (r=0.74, P<0.05). Conclusion: Compared to women with unwanted abortion, plasma Hcy of women with missed abortion increases. The elevated plasma Hcy levels can increase expression of TNFα, TRL2 and TLR4 mRNA in women with missed abortion, which may be related to missed abortion.
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