The role of TNF-α 308G>A polymorphism in the risk for ischemic stroke.

BACKGROUND

Stroke is a common health problem; however, its pathogenesis is not clear. Several studies have examined the association of -308G>A promoter polymorphism in the tumor necrosis factor-α gene (TNF-α) with ischemic stroke susceptibility. However, the results of these studies are inconsistent and the sample sizes of most of the studies were small. Thus, a meta-analysis was conducted to provide a more robust estimate of the effect of the TNF-α 308G>A polymorphism on the risk for ischemic stroke.

METHODS

Odds ratios with 95% confidence intervals were used to assess the strength of the association of TNF-α polymorphisms with ischemic stroke. Cochran's Q statistic and the inconsistency index (I) were used to explore heterogeneity. Egger's test and inverted funnel plots were used to investigate publication bias.

RESULTS

Thirteen studies met the inclusion criteria involving 3515 cases and 3949 controls. A significant association was found between TNF-α 308G>A polymorphism and the development of ischemic stroke in the Asian population. However, no statistically significant association was observed in the overall analysis and in the Caucasian population. In the subgroup analysis by age, a significant association was found in the juvenile and adult populations, showing that TNF-α 308G>A polymorphism is associated with the risk for juvenile ischemic stroke.

CONCLUSIONS

This study suggests that TNF-α 308G>A polymorphism is associated with the risk for juvenile ischemic stroke, whereas it is a protective factor for ischemic stroke in Asians and the adult population. However, in the overall analysis and in Caucasians, a significant association was not found.