Department of Cardiothoracic Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, PR China.
DNA Cell Biol. 2012 Jun;31(6):975-82. doi: 10.1089/dna.2011.1478. Epub 2012 Feb 9.
Human paraoxonase 1 (PON1) is a calcium-dependent high-density lipoprotein associated ester hydrolase that has attracted considerable attention as a candidate factor for coronary heart disease (CHD) based on its function as a key factor in lipoprotein catabolism pathways. This meta-analysis aimed to clarify the inconsistency of published studies and to establish a comprehensive picture of the relationship between PON1 activity and CHD susceptibility. A systematic search was performed from PubMed, Web of Science, EMBASE, and CNKI databases. Ratio of means (RoM) between case and control and 95% confidence intervals (CIs) were calculated using a random-effects model. The source of heterogeneity was explored by subgroup analysis and meta-regression. We identified 47 eligible studies including a total of 9853 CHD cases and 11,408 controls. The pooled analysis showed that CHD patients had a 19% lower PON1 activity than did the controls (RoM=0.81; 95% CI: 0.74-0.89, p<10(-5)). In the subgroup analyses by CHD end points, a similar effect size was observed with coronary stenosis and myocardial infarction subgroups, with corresponding RoM of 0.81 (95% CI: 0.73-0.89, p<10(-4)) and 0.83 (95% CI: 0.74-0.93, p=0.001), respectively. Decreased PON1 activity associated with CHD risk was observed in almost all subgroup analysis according to ethnicity, sample size, study design, mean age of cases, source, and type of control. Decreased PON1 activity may act as a risk factor for the development of CHD. Progressive decrease in serum PON1 activity may exist for an individual with severe disease. However, larger studies using a prospective approach are needed to confirm our results.
人对氧磷酶 1（PON1）是一种依赖钙的高密度脂蛋白相关酯酶水解酶，因其作为脂蛋白代谢途径的关键因子而成为冠心病（CHD）的候选因素，引起了相当大的关注。本荟萃分析旨在阐明已发表研究的不一致性，并建立 PON1 活性与 CHD 易感性之间关系的综合图景。从 PubMed、Web of Science、EMBASE 和 CNKI 数据库中进行了系统搜索。使用随机效应模型计算病例和对照之间的均值比（RoM）和 95%置信区间（CI）。通过亚组分析和荟萃回归探索异质性的来源。我们确定了 47 项符合条件的研究，包括 9853 例 CHD 病例和 11408 例对照。汇总分析显示，CHD 患者的 PON1 活性比对照组低 19%（RoM=0.81；95%CI：0.74-0.89，p<10(-5)）。根据 CHD 终点的亚组分析，在冠状动脉狭窄和心肌梗死亚组中观察到类似的效应大小，相应的 RoM 为 0.81（95%CI：0.73-0.89，p<10(-4)）和 0.83（95%CI：0.74-0.93，p=0.001）。根据种族、样本量、研究设计、病例平均年龄、来源和对照类型，几乎在所有亚组分析中均观察到 PON1 活性降低与 CHD 风险相关。PON1 活性降低可能是 CHD 发展的危险因素。对于病情严重的个体，血清 PON1 活性可能呈进行性降低。然而，需要更大规模的前瞻性研究来证实我们的结果。
