Clinical Institute of Nuclear Medicine and Radiation Protection, Osijek University Hospital, Osijek, Croatia.
Int J Dermatol. 2013 Jun;52(6):705-10. doi: 10.1111/j.1365-4632.2012.5813.x. Epub 2013 Mar 14.
Vitamin D receptor (VDR) gene polymorphisms have been studied as candidate variants that affect psoriasis risk. However, results have been conflicting.
We reviewed studies on VDR polymorphisms and psoriasis risk published to October 1, 2011, and quantitatively summarized associations of the most widely studied variants (FokI, TaqI, ApaI, BsmI) using meta-analysis. Associations were measured using random-effect odds ratios (ORs) combined with 95% confidence intervals (CIs).
Eleven eligible studies, encompassing 1106 cases and 1209 controls, were retrieved from electronic databases and included in this review. The results were heterogeneous, which may be partly explained by small sample bias, the phenomenon of winner's curse, and differences among populations. For FokI and ApaI polymorphisms, we did not find any evidence of association. A borderline allelic association was found for the BsmI B variant after exclusion of the earliest significant report (OR = 0.81, 95% CI 0.68-0.98; P = 0.04, inconsistency index [I2] = 12.7%). Among Caucasian subjects, the TaqI t allele was nominally associated with psoriasis risk (OR = 0.77, 95% CI 0.64-0.97; P = 0.012, I (2) = 0), with homozygous carriers (tt vs. TT, OR = 0.59, 95% CI 0.39-0.90; P = 0.01, I2 = 0) and recessive model (tt vs. Tt + TT, OR = 0.66, 95% CI 0.44-0.98; P = 0.04, I2 = 0) as protective factors. None of these associations persisted after adjustment for multiple comparisons. No publication bias was detected in this meta-analysis.
No genetic variant examined in the VDR gene showed a robust and reproducible association with risk for psoriasis. Any association that may exist is likely to be weak and potentially restricted to specific populations.
维生素 D 受体(VDR)基因多态性被认为是影响银屑病风险的候选变异。然而,结果却存在矛盾。
我们检索了截至 2011 年 10 月 1 日发表的关于 VDR 多态性与银屑病风险的研究,并通过荟萃分析定量总结了最广泛研究的变异(FokI、TaqI、ApaI、BsmI)的关联。使用随机效应比值比(OR)结合 95%置信区间(CI)来测量关联。
从电子数据库中检索到 11 项符合条件的研究,共包括 1106 例病例和 1209 例对照。结果存在异质性,这可能部分归因于小样本偏倚、赢家诅咒现象和人群差异。对于 FokI 和 ApaI 多态性,我们没有发现任何关联的证据。排除最早有意义的报告后,BsmI B 变体的边缘等位基因关联存在(OR=0.81,95%CI 0.68-0.98;P=0.04,不一致指数[I2] = 12.7%)。在白种人群中,TaqI t 等位基因与银屑病风险名义相关(OR=0.77,95%CI 0.64-0.97;P=0.012,I2=0),纯合子携带者(tt 与 TT,OR=0.59,95%CI 0.39-0.90;P=0.01,I2=0)和隐性模型(tt 与 Tt+TT,OR=0.66,95%CI 0.44-0.98;P=0.04,I2=0)为保护因素。这些关联在经过多次比较调整后均不再存在。本荟萃分析未发现发表偏倚。
VDR 基因中没有检测到的遗传变异与银屑病风险有明显且可重复的关联。任何可能存在的关联都可能很微弱,并且可能仅限于特定人群。