Zheng Ruo-Long, Zhang Hua, Jiang Wen-Long
Department of Cardiology, The Affiliated Jiangyin hospital of Medical College of Southeast University, Wuxi 214400, China.
Sci Rep. 2014 Apr 22;4:4731. doi: 10.1038/srep04731.
Rheumatic heart disease (RHD) remains a serious cardiovascular disorder across the world. Tumor necrosis factor alpha (TNF-α) codifies a potent immunomodulator and pro-inflammatory cytokine that mediates diverse pathological processes. A promoter 308G>A polymorphism in TNF-α has been implicated in RHD risk. However, the results remain controversial. Therefore, to evaluate more precise estimations of the relationship, a meta-analysis was performed. A total of 7 studies including 735 RHD cases and 926 controls were involved in this meta-analysis. Overall, our results revealed that there was a significant association with RHD risk in three genetic models (homozygous model: OR = 3.06, 95%CI = 1.22-10.60, P = 0.020; dominant model, OR = 2.03, 95%CI = 1.01-4.07, P = 0.048; and recessive model, OR = 4.26, 95%CI = 2.41-7.55, P < 0.001). Further ethnic population analysis found a significantly increased risk of RHD among Asians and Europeans. Interestingly, similar results were found among hospital-based studies. Begg's funnel plot and Egger's test did not reveal any publication bias. Taken together, this meta-analysis demonstrates that the TNF-α 308G>A polymorphism is associated with RHD susceptibility, and it contributes to the increased risk of RHD. However, additional well-designed studies with larger samples are warranted to confirm these findings.
风湿性心脏病（RHD）在全球范围内仍然是一种严重的心血管疾病。肿瘤坏死因子α（TNF-α）编码一种强大的免疫调节剂和促炎细胞因子，介导多种病理过程。TNF-α基因启动子308G>A多态性与RHD风险有关。然而，结果仍存在争议。因此，为了更精确地评估这种关系，我们进行了一项荟萃分析。该荟萃分析共纳入7项研究，包括735例RHD病例和926例对照。总体而言，我们的结果显示，在三种遗传模型中，该多态性与RHD风险存在显著关联（纯合子模型：OR = 3.06，95%CI = 1.22 - 10.60，P = 0.020；显性模型，OR = 2.03，95%CI = 1.01 - 4.07，P = 0.048；隐性模型，OR = 4.26，95%CI = 2.41 - 7.55，P < 0.001）。进一步的种族人群分析发现，亚洲人和欧洲人中RHD风险显著增加。有趣的是，在基于医院的研究中也发现了类似结果。Begg漏斗图和Egger检验未显示任何发表偏倚。综上所述，这项荟萃分析表明，TNF-α 308G>A多态性与RHD易感性相关，并导致RHD风险增加。然而，需要更多设计良好、样本量更大的研究来证实这些发现。
