Jin B, Ni H, Geshang Q, Li Y, Shen W, Shi H
Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
Tissue Antigens. 2011 Feb;77(2):107-11. doi: 10.1111/j.1399-0039.2010.01589.x.
Idiopathic dilated cardiomyopathy (IDC) has been hypothesized as a multifactorial disorder initiated by an environment trigger in individuals with predisposing human leukocyte antigen (HLA) alleles. Published data on the association between HLA-DR4 antigen and IDC risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. Studies in English-language articles were identified by a search of PubMed and Embase database (inception to June 2010). A total of 19 case-control studies including 1378 cases and 10,383 controls provided data on the association between HLA-DR4 antigen and genetic susceptibility to IDC. Overall, statistically elevated frequency of HLA-DR4 allele [OR (odds ratio), 1.58; 95% CI (confidence interval), 1.21-2.07; P = 0.0009] was found in patients with IDC compared with controls. When stratified by myocardial biopsy or non-biopsy cases, statistically increased risks were found for IDC in both subgroups. In the subgroup analysis by ethnicity, significantly increased risk was found among Europeans from 12 case-control studies (OR, 1.54; 95% CI, 1.11-2.12; P = 0.009). In conclusion, our results suggest that HLA-DR4 antigen is a low-penetrant risk factor for developing IDC in Europeans.
特发性扩张型心肌病（IDC）被认为是一种多因素疾病，由具有易感人类白细胞抗原（HLA）等位基因的个体中的环境触发因素引发。关于HLA - DR4抗原与IDC风险之间关联的已发表数据尚无定论。为了更精确地估计这种关系，进行了一项荟萃分析。通过检索PubMed和Embase数据库（从创刊至2010年6月）确定了英文文章中的研究。共有19项病例对照研究，包括1378例病例和10383例对照，提供了关于HLA - DR4抗原与IDC遗传易感性之间关联的数据。总体而言，与对照组相比，在IDC患者中发现HLA - DR4等位基因频率在统计学上升高[比值比（OR），1.58；95%置信区间（CI），1.21 - 2.07；P = 0.0009]。当按心肌活检或非活检病例分层时，在两个亚组中均发现IDC的风险在统计学上增加。在按种族进行的亚组分析中，来自12项病例对照研究的欧洲人中发现风险显著增加（OR，1.54；95% CI，1.11 - 2.12；P = 0.009）。总之，我们的结果表明，HLA - DR4抗原是欧洲人患IDC的低 penetrant 风险因素。 （注：“penetrant”这里可能是“penetrance”的错误拼写，意为“外显率”，结合语境推测这里想表达“低外显率风险因素” ）
