School of Public Health, Anhui Medical University, Hefei, China.
J Gastroenterol Hepatol. 2012 Apr;27(4):670-6. doi: 10.1111/j.1440-1746.2011.06978.x.
Environmental and genetic factors play a role in the pathogenesis and natural history of non-alcoholic fatty liver disease (NAFLD). The objective of this study was to quantitatively evaluate the association between tumor necrosis factor (TNF)-α gene promoter polymorphism at sites -308 and -238 and NAFLD susceptibility.
We performed an extensive search of relevant studies and made a meta-analysis, including eight studies with 837 NAFLD cases and 990 controls in the association between TNF-α -308 polymorphism and NAFLD; and seven studies with 771 cases and 787 controls in TNF-α -238 polymorphism.
The combined results showed that there was a significant difference in TNF-α-238 genotype distribution between NAFLD and control based on all studies (GA/AA vs GG [odds ratio = 2.06, 95% confidence interval = 1.58-2.69, P < 0.000,01]). However, the combined results based on all studies showed there was no evidence of association of TNF-α-308 genotype distribution between NAFLD cases and controls (GA/AA vs GG [odds ratio = 1.08, 95% confidence interval = 0.82-1.42, P = 0.60]). When stratifying for race, the significant results did not change materially compared with whole populations.
This meta-analysis suggested that TNF-α gene promoter polymorphism at position -238 but not -308 might be a risk factor for NAFLD.
环境和遗传因素在非酒精性脂肪性肝病（NAFLD）的发病机制和自然史中起作用。本研究的目的是定量评估肿瘤坏死因子（TNF）-α基因启动子位点-308 和-238 多态性与 NAFLD 易感性之间的关联。
我们进行了广泛的相关研究搜索，并进行了荟萃分析，包括 8 项研究，共 837 例 NAFLD 病例和 990 例对照，评估 TNF-α-308 多态性与 NAFLD 的关系；以及 7 项研究，共 771 例病例和 787 例对照，评估 TNF-α-238 多态性。
综合所有研究结果表明，TNF-α-238 基因型分布在 NAFLD 组和对照组之间存在显著差异（GA/AA 与 GG [比值比=2.06，95%置信区间=1.58-2.69，P<0.00001]）。然而，综合所有研究的结果表明，TNF-α-308 基因型分布与 NAFLD 病例和对照组之间没有关联（GA/AA 与 GG [比值比=1.08，95%置信区间=0.82-1.42，P=0.60]）。按种族分层时，与全人群相比，主要结果没有明显改变。
本荟萃分析表明，TNF-α 基因启动子-238 多态性而不是-308 多态性可能是 NAFLD 的一个危险因素。
