Wang Dan, Hu Shou-Liang, Cheng Xiang-Lin, Yang Ji-Yuan
Department of Central Laboratory, First Affiliated Hospital of Yangtze University, JingZhou, Hubei 434000, China.
Thromb Res. 2014 Dec;134(6):1323-7. doi: 10.1016/j.thromres.2014.10.003. Epub 2014 Oct 13.
Previous studies have evaluated the association between FCGR2A H131R (rs1801274) polymorphism and idiopathic (immune) thrombocytopenic purpura (ITP), but results remain inconsistent. This meta-analysis was conducted to clarify these controversies.
Literatures on PubMed/ Medline, Embase and CENTRAL databases up to September 2013 were searched by two investigators. The distributions of alleles and genotypes between cases and controls were compared by using odds ratios (ORs) and 95% confidence intervals (95% CIs). Fixed or Random-effects models were used when appropriate.
10 studies involving 553 patients and 1088 controls were available for this study, including 7 studies of Caucasian descendents, 2 studies of Asian descendents, and 1 study contained diverse ethnicity. In this studied overall population, we didn't found any significant association between the FCGR H131R polymorphism and the risk of ITP for all genetic models. But in the subgroup analysis, a significant association between FCGR H131R polymorphism and ITP susceptibility was observed in Caucasian population of childhood-onset group for H vs. R (OR = 1.246, 95% CI 1.021-1.522, p = 0.031), HH vs. HR + RR (OR = 1.562, 95% CI 1.145-2.129, p = 0.005), HH vs. HR (OR = 1.598, 95% CI 1.146-2.228, p = 0.006), HH vs. RR (OR = 1.484, 95% CI 1.005-2.191, p = 0.047). No significantly between-study heterogeneity was observed for all genotype models in Caucasian childhood-onset ITP subtype analysis. However, this association was not stable after sensitivity analysis.
Our present meta-analysis indicated that FCGR H131R polymorphism might not be associated with risk of ITP in overall population. However, in Caucasian childhood-onset subgroup, there might be an association between FCGR2A H131R polymorphism and ITP risk, which is not robust and should be explained with caution.
既往研究评估了FCGR2A H131R（rs1801274）基因多态性与特发性（免疫性）血小板减少性紫癜（ITP）之间的关联，但结果仍不一致。本荟萃分析旨在澄清这些争议。
由两名研究人员检索截至2013年9月PubMed/Medline、Embase和CENTRAL数据库中的文献。通过比值比（OR）和95%置信区间（95%CI）比较病例组和对照组之间等位基因和基因型的分布。适当情况下使用固定效应或随机效应模型。
本研究纳入10项研究，共553例患者和1088例对照，其中7项研究为白种人后裔，2项研究为亚洲人后裔，1项研究包含不同种族。在本研究的总体人群中，我们未发现FCGR H131R基因多态性与所有遗传模型的ITP风险之间存在任何显著关联。但在亚组分析中，在儿童期发病组的白种人群中，观察到FCGR H131R基因多态性与ITP易感性之间存在显著关联：H与R比较（OR = 1.246，95%CI 1.021 - 1.522，p = 0.031），HH与HR + RR比较（OR = 1.562，95%CI 1.145 - 2.129，p = 0.005），HH与HR比较（OR = 1.598，95%CI 1.146 - 2.228，p = 0.006），HH与RR比较（OR = 1.484，95%CI 1.005 - 2.191，p = 0.047）。在白种人儿童期发病ITP亚型分析中，所有基因型模型均未观察到显著的研究间异质性。然而，敏感性分析后这种关联并不稳定。
我们目前的荟萃分析表明，FCGR H131R基因多态性可能与总体人群的ITP风险无关。然而，在白种人儿童期发病亚组中，FCGR2A H131R基因多态性与ITP风险之间可能存在关联，但这种关联并不稳健，应谨慎解释。
