Division of Preventive Medicine, Department of Medicine; Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215-1204, USA.
Headache. 2010 Apr;50(4):588-99. doi: 10.1111/j.1526-4610.2009.01570.x. Epub 2009 Nov 17.
Data on the association between the MTHFR 677C>T and ACE D/I polymorphisms and migraine including aura status are conflicting.
The objective of this study is to perform a systematic review and meta-analysis on this topic.
We searched for studies published until March 2009 using electronic databases (MEDLINE, EMBASE, Science Citation Index) and reference lists of studies and reviews on the topic. Assessment for eligibility of studies and extraction of data was performed by 2 independent investigators. For each study we calculated the odds ratios (OR) and 95% confidence intervals (CI) assuming additive, dominant, and recessive genetic models. We then calculated pooled ORs and 95% CIs.
Thirteen studies investigated the association between the MTHFR 677C>T polymorphism and migraine. The TT genotype was associated with an increased risk for any migraine, which only appeared for migraine with aura (pooled OR = 1.48, 95% CI 1.02-2.13), but not for migraine without aura. Nine studies investigated the association of the ACE D/I polymorphism with migraine. The II genotype was associated with a reduced risk for migraine with aura (pooled OR = 0.71, 95% CI 0.55-0.93) and migraine without aura (pooled OR = 0.84, 95% CI 0.70-0.99). Results for both variants were driven by studies in non-Caucasian populations. Results among Caucasians did not suggest an association. Extractable data did not allow investigation of gene-gene interactions.
The MTHFR 677TT genotype is associated with an increased risk for migraine with aura, while the ACE II genotype is protective against both migraine with and without aura. Results for both variants appeared only among non-Caucasian populations. There was no association among Caucasians.
关于 MTHFR 677C>T 和 ACE D/I 多态性与偏头痛（包括先兆偏头痛）之间关联的数据存在冲突。
本研究旨在对此问题进行系统评价和荟萃分析。
我们使用电子数据库（MEDLINE、EMBASE、科学引文索引）和关于该主题的研究和综述的参考文献列表，检索截至 2009 年 3 月发表的研究。两名独立的研究者对研究的合格性进行评估并提取数据。对于每一项研究，我们按照加性、显性和隐性遗传模型计算了比值比（OR）和 95%置信区间（CI）。然后我们计算了合并的 OR 和 95%CI。
有 13 项研究调查了 MTHFR 677C>T 多态性与偏头痛之间的关联。TT 基因型与任何类型偏头痛的风险增加相关，这种关联仅见于有先兆偏头痛（合并 OR=1.48，95%CI 1.02-2.13），而与无先兆偏头痛无关。有 9 项研究调查了 ACE D/I 多态性与偏头痛的关联。II 基因型与有先兆偏头痛（合并 OR=0.71，95%CI 0.55-0.93）和无先兆偏头痛（合并 OR=0.84，95%CI 0.70-0.99）的风险降低相关。这两种变异的结果均由非白种人人群的研究驱动。在白种人中，结果并不提示存在关联。可提取的数据不允许研究基因-基因相互作用。
MTHFR 677TT 基因型与有先兆偏头痛的风险增加相关，而 ACE II 基因型对有先兆和无先兆偏头痛均具有保护作用。这两种变异的结果仅见于非白种人群。在白种人中不存在关联。
