Ma Jinlan, Li Yan, Zhou Fang, Xu Xiaoyi, Guo Gang, Qu Yi
Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.
Mol Vis. 2012;18:2352-60. Epub 2012 Sep 10.
The Pro12Ala polymorphism of the peroxisome proliferator-activated receptor-γ2 (PPARγ2) gene is reported to be associated with diabetes. However, the gene's association with diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) has been investigated in numerous epidemiologic studies with controversial results. This meta-analysis aimed to collectively assess the association of the Pro12Ala polymorphism with DR in T2DM.
An electronic literature search was conducted on PubMed, ISI Web of Knowledge, EMBASE, and the China National Knowledge Internet. A dominant model [(Pro/Ala +Ala/Ala) versus Pro/Pro] was used to ensure adequate statistical power. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the fixed effect model. Potential sources of heterogeneity and bias were explored.
This meta-analysis included genotype data from 2,720 cases with DR and 2,450 controls free of DR from eight eligible publications. The results showed the Ala allele had a protective effect on DR in T2DM (OR=0.81; 95% CI: 0.68-0.98, p=0.03). There was no significant evidence against homogeneity (I(2)=46%, P(heterogeneity)=0.07). The sensitivity analysis showed a robust association of the Pro12Ala polymorphism with DR in T2DM after a study involving Caucasians that presented a big effect on heterogeneity (OR=0.75; 95% CI: 0.62-0.91, p=0.003) was excluded. Possible ethnic differences in the association of the Pro12Ala single nucleotide polymorphism and DR were demonstrated; a significant association was illustrated in the Caucasian subgroup (OR=0.74; 95% CI: 0.59-0.94, p=0.01) but was not found in the Asian subgroup (OR=0.77; 95% CI: 0.55-1.07, p=0.12). No publication bias was observed.
This meta-analysis suggested a significant association exists between the Pro12Ala polymorphism and DR in T2DM with ethnic differences. The Ala allele had a significant protective effect against DR in T2DM.
据报道，过氧化物酶体增殖物激活受体γ2（PPARγ2）基因的Pro12Ala多态性与糖尿病相关。然而，众多流行病学研究对该基因与2型糖尿病（T2DM）患者糖尿病视网膜病变（DR）之间的关联进行了调查，结果存在争议。本荟萃分析旨在综合评估Pro12Ala多态性与T2DM患者DR之间的关联。
在PubMed、ISI Web of Knowledge、EMBASE和中国知网进行电子文献检索。采用显性模型[（Pro/Ala + Ala/Ala）对Pro/Pro]以确保足够的统计效力。使用固定效应模型计算粗比值比（OR）和95%置信区间（CI）。探讨异质性和偏倚的潜在来源。
本荟萃分析纳入了来自8篇合格出版物的2720例DR患者和2450例无DR对照的基因型数据。结果显示，Ala等位基因对T2DM患者的DR具有保护作用（OR = 0.81；95%CI：0.68 - 0.98，p = 0.03）。没有显著证据表明存在异质性（I² = 46%，P（异质性）= 0.07）。敏感性分析显示，在排除一项对异质性影响较大的涉及白种人的研究后，Pro12Ala多态性与T2DM患者的DR之间存在稳健关联（OR = 0.75；95%CI：0.62 - 0.91，p = 0.003）。Pro12Ala单核苷酸多态性与DR之间的关联可能存在种族差异；在白种人亚组中显示出显著关联（OR = 0.74；95%CI：0.59 - 0.94，p = 0.01），但在亚洲亚组中未发现（OR = 0.77；95%CI：0.55 - 1.07，p = 0.12）。未观察到发表偏倚。
本荟萃分析表明，Pro12Ala多态性与T2DM患者的DR之间存在显著关联，且存在种族差异。Ala等位基因对T2DM患者的DR具有显著保护作用。
