Zhou Donghui, Hu Weina, Wang Qi, Jin Yuanzhe
Department of Cardiology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.
Department of Cardiology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.
Heart Lung Circ. 2014 Jun;23(6):578-85. doi: 10.1016/j.hlc.2014.01.003. Epub 2014 Jan 22.
Many studies have investigated the association between glutathione S-transferase M1 (GSTM1) null genotype and the risk of coronary heart disease (CHD). However, the effect of the GSTM1 null genotype on CHD is still unclear because of apparent inconsistencies among those studies. A meta-analysis was performed to characterise the relationship more accurately.
Pubmed, Embase, and Web of Science were searched. We estimated the summary odds ratio (OR) with a 95% confidence interval (95% CI) to assess the association.
Up to 26 case-control studies with 13,929 CHD cases and 33,667 control cases were included into this meta-analysis. Meta-analysis of the 26 studies showed that GSTM1 null genotype was associated with the risk of CHD (random effects OR=1.35, 95% CI 1.00 to 1.83). After adjustment for heterogeneity, meta-analysis showed that GSTM1 null genotype was not associated with increased risk of CHD in the total population (fixed effects OR=1.01, 95% CI 0.95 to 1.07). In the subgroup analysis by ethnicity, increased risks were not found for either Caucasians (OR=1.36, 95% CI=0.96-1.92) or Asians (OR=1.28, 95% CI=0.91-1.80). When stratified by smoking status, in the subgroup of smokers, GSTM1 null genotype was significantly associated with increased CHD risk (random effects OR=1.64, 95% CI 1.02 to 2.64). No evidence of publication bias was observed.
In conclusion, this meta-analysis suggested that there is overall lack of association between GSTM1 genotypes and CHD risk, however, GSTM1 null genotype when combining with smoking history may contribute to CHD susceptibility.
许多研究调查了谷胱甘肽S-转移酶M1（GSTM1）基因缺失型与冠心病（CHD）风险之间的关联。然而，由于这些研究结果明显不一致，GSTM1基因缺失型对冠心病的影响仍不明确。进行了一项荟萃分析以更准确地描述这种关系。
检索了PubMed、Embase和科学网。我们估计了汇总比值比（OR）及95%置信区间（95%CI）以评估这种关联。
本荟萃分析纳入了多达26项病例对照研究，共13929例冠心病病例和33667例对照。对这26项研究的荟萃分析表明，GSTM1基因缺失型与冠心病风险相关（随机效应OR = 1.35，95%CI为1.00至1.83）。在对异质性进行校正后，荟萃分析表明，在总体人群中，GSTM1基因缺失型与冠心病风险增加无关（固定效应OR = 1.01，95%CI为0.95至1.07）。在按种族进行的亚组分析中，白种人（OR = 1.36，95%CI = 0.96 - 1.92）或亚洲人（OR = 1.28，95%CI = 0.91 - 1.80）均未发现风险增加。按吸烟状况分层时，在吸烟者亚组中，GSTM1基因缺失型与冠心病风险增加显著相关（随机效应OR = 1.64，95%CI为1.02至2.64）。未观察到发表偏倚的证据。
总之，本荟萃分析表明，GSTM1基因与冠心病风险总体上缺乏关联，然而，GSTM1基因缺失型与吸烟史相结合可能会增加患冠心病的易感性。
