Liu Jie, Jia Xin, Li Haifeng, Jia Senhao, Zhang Minhong, Xu Yongle, Du Xin, Zhang Nianrong, Lu Weihang, Guo Wei
Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China Department of Vascular and Endovascular Surgery, Shanxian Dongda Hospital, Heze, Shandong Department of Nephrology, Chinese-Japan Friendship Hospital, Beijing, China.
Medicine (Baltimore). 2016 Sep;95(36):e4793. doi: 10.1097/MD.0000000000004793.
Abdominal aortic aneurysm (AAA) is a life-threatening condition. A number of studies reported the association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and AAA risk, but substantial controversial findings were observed and the strength of the association remains unclear.
The aim of this study was to investigate the aforementioned association in the overall population and different subgroups.
PUBMED and EMBASE databases were searched until March 2016 to identify eligible studies, restricted to humans and articles published in English. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the susceptibility to AAA. Subgroup meta-analyses were conducted on features of the population, such as ethnicity, sex of the participants, and study design (source of control).
Twelve case-control studies on MTHFR C677T polymorphism and AAA risk, including 3555 cases and 6568 case-free controls were identified. The results revealed no significant association between the MTHFR C677T polymorphism and AAA risk in the overall population and within Caucasian or Asian subpopulations in all 5 genetic models. Further subgroup meta-analysis indicated that significantly increased risks were observed among cases with a mean age <70 years (OR = 1.73, 95% CI = 1.10-2.12, P = 0.02), cases with prevalence of smoking <60% (OR = 1.39, 95% CI = 1.02-1.90, P = 0.04), and cases with aneurysm diameter ≥55 mm (OR = 1.55, 95% CI = 1.07-2.24, P = 0.02) in the dominant genetic model. No publication bias was detected in the present study.
In conclusion, our comprehensive meta-analysis suggests that the MTHFR C677T polymorphism may play an important role in AAA susceptibility, especially in younger, non-smoking, larger AAA-diameter subgroups of patients.
腹主动脉瘤(AAA)是一种危及生命的疾病。多项研究报道了亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性与AAA风险之间的关联,但观察到大量有争议的结果,且这种关联的强度仍不明确。
本研究旨在调查总体人群及不同亚组中的上述关联。
检索截至2016年3月的PUBMED和EMBASE数据库,以识别符合条件的研究,限于人类及英文发表的文章。汇总比值比(OR)和95%置信区间(CI)用于评估AAA易感性。对人群特征进行亚组Meta分析,如种族、参与者性别和研究设计(对照来源)。
识别出12项关于MTHFR C677T基因多态性与AAA风险的病例对照研究,包括3555例病例和6568例无病例对照。结果显示,在所有5种遗传模型中,总体人群以及白种人或亚洲亚人群中,MTHFR C677T基因多态性与AAA风险之间无显著关联。进一步的亚组Meta分析表明,在显性遗传模型中,平均年龄<70岁的病例(OR = 1.73,95%CI = 1.10 - 2.12,P = 0.02)、吸烟率<60%的病例(OR = 1.39,95%CI = 1.02 - 1.90,P = 0.04)以及动脉瘤直径≥55mm的病例(OR = 1.55,95%CI = 1.07 - 2.24,P = 0.02)中观察到风险显著增加。本研究未检测到发表偏倚。
总之,我们的综合Meta分析表明,MTHFR C677T基因多态性可能在AAA易感性中起重要作用,尤其是在年龄较小、不吸烟、动脉瘤直径较大的亚组患者中。