Department of Surgery Laboratory, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, P.R. China.
Wien Klin Wochenschr. 2012 Oct;124(19-20):671-7. doi: 10.1007/s00508-012-0223-0. Epub 2012 Sep 18.
Two common variations of peroxisome proliferator-activated receptor γ (PPARG), P12A (Pro12Ala, rs1801282), and C161T (His447His, rs3856806), are thought to have an effect on susceptibility to coronary heart disease (CHD), but the results are inconsistent. Therefore, a meta-analysis of published studies was performed.
The electronic databases, PubMed, Embase, Web of Science, and CNKI (China National Knowledge Infrastructure) were searched for studies to include in the present meta-analysis (last search was updated on 30 Aug. 2011). Twenty studies testing the association between PPARG gene polymorphisms and CHD were examined: 12 studies of P12A; 8 studies of C161T. Overall and ethnicity-specific summary odds ratios and corresponding 95 % confidence intervals for CHD associated with these polymorphisms were estimated using fixed- and random-effects models. Heterogeneity and publication bias were evaluated. A total of 20 studies including 5,795 cases and 9,069 controls were included in this meta-analysis.
No significant associations were found in carriers of the rare Ala allele of the P12A polymorphism versus the common Pro/Pro genotype among the studies with both of the fixed-effect and random-effect model. In the subgroup analyses by ethnicity, source of control and type of study, no significant risks were found. For PPARG C161T, carriers of the T variant of C161T polymorphism were associated with an increased risk of CHD (OR = 1.182, 95 % CI: 1.023-1.341, P(heterogeneity) = 0.002), and in the stratified analysis by ethnicity and source of controls, the contrast of CT + TT vs. CC all produced significant association in Asian and hospital-based controls (OR = 1.276, 95 % CI: 1.084-1.468, P(heterogeneity) = 0.055; OR = 1.164, 95 % CI: 1.001-1.326, P(heterogeneity) = 0.002),when the fixed-effect model was used. But they were all insignificant with the random-effect model.
This meta-analysis suggests that the PPARG C161T polymorphism marginally contributes to increased susceptibility to CHD and marginally increased association between PPARG H477H polymorphism and CHD also appeared in Asian and hospital-based controls. But PPARG P12A polymorphism is not associated with CHD risk.
过氧化物酶体增殖物激活受体 γ(PPARG)的两种常见变异体,即 P12A(脯氨酸 12 到丙氨酸,rs1801282)和 C161T(组氨酸 447 到组氨酸,rs3856806),被认为与冠心病(CHD)的易感性有关,但结果并不一致。因此,进行了一项对已发表研究的荟萃分析。
检索电子数据库 PubMed、Embase、Web of Science 和中国知网(CNKI),以纳入本次荟萃分析的研究(最后一次检索更新日期为 2011 年 8 月 30 日)。共 20 项研究检验了 PPARG 基因多态性与 CHD 之间的关系:12 项研究检测了 P12A;8 项研究检测了 C161T。使用固定效应模型和随机效应模型估计了与这些多态性相关的 CHD 的总体和特定种族的汇总优势比及其相应的 95%置信区间。评估了异质性和发表偏倚。本荟萃分析共纳入了 20 项研究,包括 5795 例病例和 9069 例对照。
在固定效应模型和随机效应模型中,携带 P12A 多态性罕见的丙氨酸等位基因的个体与常见的脯氨酸/脯氨酸基因型相比,与 CHD 无关。在按种族、对照来源和研究类型进行的亚组分析中,未发现明显的风险。对于 PPARG C161T,C161T 多态性的 T 变异携带者患 CHD 的风险增加(OR=1.182,95%CI:1.023-1.341,P(异质性)=0.002),按种族和对照来源分层分析,CT+TT 与 CC 相比,在亚洲人群和医院人群对照中均产生显著关联(OR=1.276,95%CI:1.084-1.468,P(异质性)=0.055;OR=1.164,95%CI:1.001-1.326,P(异质性)=0.002),当使用固定效应模型时。但当使用随机效应模型时,它们均不具有统计学意义。
本荟萃分析提示,PPARG C161T 多态性可能导致 CHD 的易感性增加,而 PPARG H477H 多态性与 CHD 之间的关联也可能出现在亚洲人群和医院人群对照中。但 PPARG P12A 多态性与 CHD 风险无关。