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维生素D受体基因多态性与冠状动脉疾病的关联:一项系统评价和荟萃分析

The Associations Between the Polymorphisms of Vitamin D Receptor and Coronary Artery Disease: A Systematic Review and Meta-Analysis.

作者信息

Lu Shuai, Guo Shizhe, Hu Fen, Guo Yushu, Yan Lianhua, Ma Wenhan, Wang Ya, Wei Yuzhen, Zhang Zhaoyun, Wang Zhaohui

机构信息

From the Department of Cardiology (SL, FH, LY, WM, YW, YW, ZW), Union Hospital, Huazhong University of Science and Technology, Wuhan; Department of Endocrinology and Metabolism (SG, ZZ), Huashan Hospital, Fudan University, Shanghai; and Department of Health Management (YG), Hangzhou Normal University, Hangzhou, People's Republic of China.

出版信息

Medicine (Baltimore). 2016 May;95(21):e3467. doi: 10.1097/MD.0000000000003467.

Abstract

Vitamin D receptor (VDR) polymorphisms were indicated to be associated with coronary artery disease (CAD); however, published studies reported inconsistent results.The aim of this meta-analysis is to reach a more accurate estimation of the relationship between VDR genetic polymorphisms and CAD risk.Eligible studies were retrieved by searching PubMed, Embase, VIP, Wanfang and China National Knowledge Infrastructure databases. Included and excluded criteria were formulated. The case group was patients with CAD, and the control group was healthy subjects. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate VDR polymorphisms associations with CAD risk. Heterogeneity was evaluated by Q statistic and I statistic.Seven studies of a total of 2306 CAD patients and 4151 control subjects met the inclusion criteria. The pooled results from Taq1 showed increased risk in allelic model (OR = 1.14, 95% CI = 1.02-1.28), dominant model (OR = 1.21, 95% CI = 1.02-1.43), heterozygote model (OR = 1.19, 95% CI = 1.00-1.1.42), and homozygote model (OR = 1.27, 95% CI = 1.01-1.61). Besides, Fok1 T > C showed decreased risk in allelic model (OR = 0.81, 95% CI = 0.65-1.00) and Fok1 A > G also showed decreased risk in allelic model (OR = 0.67, 95% CI = 0.45-1.00) and recessive model (OR = 0.55, 95% CI = 0.31-0.97). In Caucasian subgroup, Bsm1showed increased risk in allelic model (OR = 1.23, 95% CI = 1.02-1.47), heterozygote model (OR = 1.20, 95% CI = 1.00-1.44), and homozygote model (OR = 1.22, 95% CI = 1.02-1.45). In CAD patients with type 2 diabetes mellitus (T2DM), Apa1showed a decreased risk in heterozygote model (OR = 0.80, 95% CI = 0.66-0.98); however, increased risk in recessive model (OR = 5.00, 95% CI = 2.74-9.13) was discovered in CAD patients without T2DM.The Fok1 polymorphism may play a protective role in CAD, and the possible protective role in Apa1 CA genotype in CAD patients with T2DM needs further studies. The Taq1 polymorphism is found to be associated with a significant increase in CAD risk based on our analysis; moreover, increased risk in Apa1 polymorphism in CAD patients without T2DM and Bsm1 polymorphism in Caucasian group is also detected.

摘要

维生素D受体(VDR)基因多态性被认为与冠状动脉疾病(CAD)有关;然而,已发表的研究报告结果并不一致。本荟萃分析的目的是更准确地评估VDR基因多态性与CAD风险之间的关系。通过检索PubMed、Embase、维普、万方和中国知网数据库获取符合条件的研究。制定了纳入和排除标准。病例组为CAD患者,对照组为健康受试者。采用汇总比值比(OR)和95%置信区间(CI)评估VDR基因多态性与CAD风险的关联。通过Q统计量和I统计量评估异质性。共有7项研究,涉及2306例CAD患者和4151例对照受试者,符合纳入标准。Taq1的汇总结果显示,在等位基因模型(OR = 1.14,95% CI = 1.02 - 1.28)、显性模型(OR = 1.21,95% CI = 1.02 - 1.43)、杂合子模型(OR = 1.19,95% CI = 1.00 - 1.42)和纯合子模型(OR = 1.27,95% CI = 1.01 - 1.61)中风险增加。此外,Fok1 T>C在等位基因模型中显示风险降低(OR = 0.81,95% CI = 0.65 - 1.00),Fok1 A>G在等位基因模型中也显示风险降低(OR = 0.67,95% CI = 0.45 - 1.00),在隐性模型中(OR = 0.55,95% CI = 0.31 - 0.97)也是如此。在白种人亚组中,Bsm1在等位基因模型(OR = 1.23,95% CI = 1.02 - 1.47)、杂合子模型(OR = 1.20,95% CI = 1.00 - 1.44)和纯合子模型(OR = 1.22,95% CI = 1.02 - 1.45)中显示风险增加。在2型糖尿病(T2DM)的CAD患者中,Apa1在杂合子模型中显示风险降低(OR = 0.80,95% CI = 0.66 - 0.98);然而,在无T2DM的CAD患者中发现隐性模型风险增加(OR = 5.00,95% CI = 2.74 - 9.13)。Fok1多态性可能在CAD中起保护作用,Apa1 CA基因型在T2DM的CAD患者中可能的保护作用需要进一步研究。基于我们的分析,发现Taq1多态性与CAD风险显著增加有关;此外,还检测到无T2DM的CAD患者中Apa1多态性风险增加以及白种人群中Bsm1多态性风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc32/4902336/2fb84ac0164f/medi-95-e3467-g003.jpg

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