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亚甲基四氢叶酸还原酶 C677T 多态性与先天性心脏病风险:来自 29 项病例对照和 TDT 研究的证据。

MTHFR C677T polymorphism and risk of congenital heart defects: evidence from 29 case-control and TDT studies.

机构信息

Children's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.

出版信息

PLoS One. 2013;8(3):e58041. doi: 10.1371/journal.pone.0058041. Epub 2013 Mar 11.

Abstract

BACKGROUND

Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme for folate metabolism in humans; it is encoded by the MTHFR gene. Several studies have assessed the association between MTHFR C677T polymorphism and the risk of congenital heart defects (CHDs), while the results were inconsistent.

METHODS AND FINDINGS

Multiple electronic databases were searched to identify relevant studies published up to July 22, 2012. Data from case-control and TDT studies were integrated in an allelic model using the Catmap and Metafor software. Twenty-nine publications were included in this meta-analysis. The overall meta-analysis showed significant association between MTHFR C677T polymorphism and CHDs risk in children with heterogeneity (P heterogeneity = 0.000) and publication bias (P egger = 0.039), but it turned into null after the trim-and-fill method was implemented (OR = 1.12, 95% CI = 0.95-1.31). Nevertheless, positive results were obtained after stratified by ethnicity and sample size in all subgroups except the mixed population. For mothers, there was significant association between the variant and CHDs without heterogeneity (P heterogeneity = 0.150, OR = 1.16, 95% CI = 1.05-1.29) and publication bias (P egger = 0.981). However, the results varied across each subgroup in the stratified analysis of ethnicity and sample size.

CONCLUSIONS

Both infant and maternal MTHFR C677T polymorphisms may contribute to the risk of CHDs.

摘要

背景

亚甲基四氢叶酸还原酶(MTHFR)是人类叶酸代谢中的重要酶,由 MTHFR 基因编码。已有多项研究评估了 MTHFR C677T 多态性与先天性心脏病(CHD)风险之间的关系,但结果不一致。

方法和发现

检索多个电子数据库,以确定截至 2012 年 7 月 22 日发表的相关研究。使用 Catmap 和 Metafor 软件,以等位基因模型整合病例对照和 TDT 研究的数据。这项荟萃分析共纳入 29 项研究。总体荟萃分析显示,MTHFR C677T 多态性与儿童 CHD 风险之间存在显著关联,但存在异质性(P 异质性=0.000)和发表偏倚(P 趋同=0.039),但采用填充和修剪法后关联变为无效(OR=1.12,95%CI=0.95-1.31)。然而,除了混合人群外,在按种族和样本量分层的所有亚组中,结果均为阳性。对于母亲,该变体与 CHD 之间存在显著关联,且无异质性(P 异质性=0.150,OR=1.16,95%CI=1.05-1.29)和发表偏倚(P 趋同=0.981)。然而,在按种族和样本量分层的分析中,每个亚组的结果均存在差异。

结论

婴儿和母亲的 MTHFR C677T 多态性均可能增加 CHD 风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63f6/3594197/08dbc757f753/pone.0058041.g001.jpg

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