Analysis of the association between TRPM8 and TRPA1 gene polymorphisms and the occurrence of perioperative shivering in Chinese women undergoing cesarean section

doi:10.12092/j.issn.1009-2501.2026.04.003

Abstract

Abstract:

AIM: To explore the impact of TRPM8 and TRPA1 gene polymorphisms on the occurrence of perioperative shivering in Chinese women undergoing cesarean delivery and to analyze the risk factors for perioperative shivering. METHODS: A total of 332 Chinese women undergoing cesarean delivery under lumbar anesthesia were enrolled, and the patients' vital signs and potential risk factors for shivering during anesthesia and surgery were recorded. Polymerase chain reaction-restriction fragment length polymorphism analysis was applied to genotype all patients with the gene locus rs1987842, rs2052030, rs7593557, rs1004478, rs13004520, rs10203291 of TRPM8 and the rs3758059, rs10085964, rs28546865, rs9298197, rs959976 gene locus of TRPA1. Finally, logistic regression analysis was conducted to assess all potential perioperative shivering risks. RESULTS: The incidence of perioperative shivering after single lumbar anesthesia in 332 women was 48.5%, with a total of 161 cases observed. The results of logistics multifactorial analysis showed that the first cesarean delivery, operating room temperature below 23 °C, BMI ≤ 28 kg/m², SNP locus rs10203291 CC genotype of TRPM8, and the SNP locus rs9298197 TT genotype of TRPA1 were risk factors for perioperative shivering (P<0.05). CONCLUSION: TT genotype of TRPA1 gene rs9298197 and CC genotype of TRPM8 gene rs10203291, first cesarean delivery, operating room temperature below 23 °C, and BMI less than 28 kg/m² were risk factors for perioperative shivering during cesarean delivery.

Key words: cesarean section, shivering, risk factors, TRPM8, TRPA1

CLC Number:

R614
R394

Shanshan ZHAO, Saiying WANG, Kaiming DUAN, Yingyong ZHOU. Analysis of the association between TRPM8 and TRPA1 gene polymorphisms and the occurrence of perioperative shivering in Chinese women undergoing cesarean section[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(4): 451-459.

Figures/Tables 6

References 39

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Item	No-shivering (n=171)	Shivering (n=161)	t/χ2	P
Age (y)	32.49±3.91	31.66±3.74	1.966	0.05
Height (cm)	158.97±4.67	158.29±4.46	1.366	0.173
Neonatal weight (g)	3315.85±504.24	3307.67±552.30	0.141	0.888
Total volume out (mL)	941.81±430.08	999.41±528.08	?1.086	0.278
Total volume in (mL)	508.36±284.82	521.03±400.38	?0.334	0.739
Temperature before anesthesia T (℃)	37.12±0.27	37.14±0.29	?0.836	0.389
Temperature after delivery T (℃)	36.92±0.28	36.93±0.33	?0.549	0.583
Temperature after surgery T (℃)	36.97±0.43	37.03±0.96	?0.727	0.468
Length of surgery (h)	0.70±0.24	0.72±0.28	?0.712	0.477
BMI (kg/m²)
≤28	97(56.7)	112(69.6)	5.862	0.015*
>28	74(43.3)	49(30.4)	5.862	0.015*
Operating room temperature (℃)
≤23	79(46.2)	97(60.2)	6.571	0.010*
>23	92(53.8)	64(39.8)	6.571	0.010*
Secondary dissection
No	64(37.43)	83(51.55)	6.707	0.010*
Yes	107(62.57)	78(48.45)	6.707	0.010*
History of shivering
0	161(94.15)	151(93.79)	0.019	0.889
1	10(5.85)	10(6.21)	0.019	0.889
Emergency
No	123(71.93)	104(64.60)	2.062	0.151
Yes	48(28.07)	57(35.40)	2.062	0.151
Diabetes
No	142(83.04)	133(82.61)	0.011	0.917
Yes	29(16.96)	28(17.39)	0.011	0.917
Hyperthyroidism
No	168(98.25)	158(98.14)	0.114	0.736
Yes	3(1.75)	3(1.86)	0.114	0.736
Hypothyroidism
No	149(87.13)	132(81.99)	1.690	0.194
Yes	22(12.87)	29(18.01)	1.690	0.194
Hypertension
No	160(93.57)	152(94.41)	0.104	0.747
Yes	11(6.43)	9(5.59)	0.104	0.747

Item	No-shivering (n=171)	Shivering (n=161)	t/χ2	P
Age (y)	32.49±3.91	31.66±3.74	1.966	0.05
Height (cm)	158.97±4.67	158.29±4.46	1.366	0.173
Neonatal weight (g)	3315.85±504.24	3307.67±552.30	0.141	0.888
Total volume out (mL)	941.81±430.08	999.41±528.08	?1.086	0.278
Total volume in (mL)	508.36±284.82	521.03±400.38	?0.334	0.739
Temperature before anesthesia T (℃)	37.12±0.27	37.14±0.29	?0.836	0.389
Temperature after delivery T (℃)	36.92±0.28	36.93±0.33	?0.549	0.583
Temperature after surgery T (℃)	36.97±0.43	37.03±0.96	?0.727	0.468
Length of surgery (h)	0.70±0.24	0.72±0.28	?0.712	0.477
BMI (kg/m²)
≤28	97(56.7)	112(69.6)	5.862	0.015*
>28	74(43.3)	49(30.4)	5.862	0.015*
Operating room temperature (℃)
≤23	79(46.2)	97(60.2)	6.571	0.010*
>23	92(53.8)	64(39.8)	6.571	0.010*
Secondary dissection
No	64(37.43)	83(51.55)	6.707	0.010*
Yes	107(62.57)	78(48.45)	6.707	0.010*
History of shivering
0	161(94.15)	151(93.79)	0.019	0.889
1	10(5.85)	10(6.21)	0.019	0.889
Emergency
No	123(71.93)	104(64.60)	2.062	0.151
Yes	48(28.07)	57(35.40)	2.062	0.151
Diabetes
No	142(83.04)	133(82.61)	0.011	0.917
Yes	29(16.96)	28(17.39)	0.011	0.917
Hyperthyroidism
No	168(98.25)	158(98.14)	0.114	0.736
Yes	3(1.75)	3(1.86)	0.114	0.736
Hypothyroidism
No	149(87.13)	132(81.99)	1.690	0.194
Yes	22(12.87)	29(18.01)	1.690	0.194
Hypertension
No	160(93.57)	152(94.41)	0.104	0.747
Yes	11(6.43)	9(5.59)	0.104	0.747

SNP	Gene	No-shivering	Shivering	Additive		Dominant		Recessive
SNP	Gene	No-shivering	Shivering	P	OR(95%CI)	P	OR(95%CI)	P	OR(95%CI)
rs3758059^b	AA	10	7	0.144	reference	0.102	0.694 (0.447-1.077)	0.545	1.357 (0.504-3.656)
	CA	54	67	0.272	1.772 (0.633-4.966)
	CC	106	85	0.791	1.146 (0.418-3.136)
rs10085964^b	CC	4	7	0.611	reference	0.773	0.936 (0.596-1.469)	0.321	0.537 (0.154-1.869)
	TC	55	52	0.342	0.540 (0.149-1.954)
	TT	109	102	0.323	0.535 (0.152-1.881)
rs28546865	GG	81	84	0.184	reference	0.072	0.440 (0.176-1.100)	0.381	0.825 (0.536-1.269)
	AG	74	70	0.687	0.912 (0.583-1.426)
	AA	16	7	0.066	0.422 (0.165-1.079)
rs9298197^b	GT	24	11	0.031^a	reference
	TT	144	148	0.031^a	2.242 (1.060-4.745)
rs959976^b	TT	67	75		reference	0.091	0.561 (0.285-1.103)	0.22	0.761 (0.491-1.178)
	TC	75	71	0.477	0.846 (0.533-1.343)
	CC	26	15	0.067	0.515 (0.252-1.054)

SNP	Gene	No-shivering	Shivering	Additive		Dominant		Recessive
SNP	Gene	No-shivering	Shivering	P	OR(95%CI)	P	OR(95%CI)	P	OR(95%CI)
rs3758059^b	AA	10	7	0.144	reference	0.102	0.694 (0.447-1.077)	0.545	1.357 (0.504-3.656)
	CA	54	67	0.272	1.772 (0.633-4.966)
	CC	106	85	0.791	1.146 (0.418-3.136)
rs10085964^b	CC	4	7	0.611	reference	0.773	0.936 (0.596-1.469)	0.321	0.537 (0.154-1.869)
	TC	55	52	0.342	0.540 (0.149-1.954)
	TT	109	102	0.323	0.535 (0.152-1.881)
rs28546865	GG	81	84	0.184	reference	0.072	0.440 (0.176-1.100)	0.381	0.825 (0.536-1.269)
	AG	74	70	0.687	0.912 (0.583-1.426)
	AA	16	7	0.066	0.422 (0.165-1.079)
rs9298197^b	GT	24	11	0.031^a	reference
	TT	144	148	0.031^a	2.242 (1.060-4.745)
rs959976^b	TT	67	75		reference	0.091	0.561 (0.285-1.103)	0.22	0.761 (0.491-1.178)
	TC	75	71	0.477	0.846 (0.533-1.343)
	CC	26	15	0.067	0.515 (0.252-1.054)

SNP	Gene	No-shivering	Shivering	Additive		Dominant		Recessive
SNP	Gene	No-shivering	Shivering	P	OR(95%CI)		OR(95%CI)		OR(95%CI)
rs1987842^b	GG	137	138	0.480	reference	0.972	10.051 (0.065-16.941)	0.237	0.695 (0.379-1.273)
	AG	29	20	0.227	0.685 (0.369-1.269)
	AA	1	1	0.996	0.993 (0.061-16.03)
rs2052030	CC	9	4	0.410	reference	0.529	1.156 (0.736-1.815)	0.192	2.181 (0.658-7.226)
	GC	54	50	0.238	2.083 (0.603-7.192)
	GG	108	107	0.183	2.229 (0.666-7.459)
rs7593557	GG	59	55	0.652	reference	0.467	0.827 (0.494-1.382)	0.827	1.052 (0.666-1.662)
	GA	63	68	0.567	1.158 (0.701-1.914)
	AA	42	35	0.705	0.894 (0.501-1.596)
rs1004478	CC	89	76	0.646	reference	0.99	0.995 (0.475-2.086)	0.378	1.214 (0.789-1.868)
	GC	66	70	0.35	1.242 (0.788-1.957)
	GG	16	15	0.812	1.098 (0.509-2.366)
rs13004520	GG	141	139	0.679	reference	0.693	1.307 (0.345-4.959)	0.594	0.838 (0.437-1.607)
	GC	19	14	0.433	0.747 (0.361-1.549)
	CC	4	5	0.727	1.268 (0.334-4.821)
rs10203291	CC	125	133	0.039^a	reference
	CA	46	28	0.039^a	0.572 (0.337-0.971)