Zhang Mu, Zhao Yu, Liu Qiong
Department of Emergency and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
APMIS. 2017 May;125(5):459-467. doi: 10.1111/apm.12661. Epub 2017 Mar 15.
Previous studies have reported the relationship between tumor necrosis factor-α (TNF-α) -308G/A and -238G/A polymorphisms and sepsis risk with inconsistent results. The aim of this study was to estimate the association of the two polymorphisms with risk of sepsis or sepsis-related mortality using a meta-analysis. PubMed, Embase, and Web of Science databases were searched up to June 20 2016. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed or random effect model. Twenty-six studies were included in this meta-analysis. Overall, an increased sepsis risk of TNF-α -308G/A was observed (GA vs GG: OR = 1.43, 95% CI: 1.07-1.92; GA/AA vs GG: OR = 1.42, 95% CI: 1.06-1.89). Subgroup analyses showed that the significant association was found in Asians (GA vs GG: OR = 1.63, 95% CI: 1.01-2.63) and adult patients. Similarly, an increased sepsis risk of TNF-α -238G/A was observed in overall and subgroup analyses. However, no significant association was found between TNF-α -308G/A and -238G/A polymorphisms and sepsis-related mortality. These findings indicate that both TNF-α -308G/A and -238G/A polymorphisms were associated with increased risks of sepsis but not sepsis-related mortality. Further studies with larger sample size are needed to confirm these results.
以往研究报道了肿瘤坏死因子-α（TNF-α）-308G/A和-238G/A基因多态性与脓毒症风险之间的关系，但结果并不一致。本研究旨在通过荟萃分析评估这两种基因多态性与脓毒症风险或脓毒症相关死亡率之间的关联。检索了截至2016年6月20日的PubMed、Embase和Web of Science数据库。使用固定效应模型或随机效应模型计算合并比值比（OR）和95%置信区间（CI）。本荟萃分析纳入了26项研究。总体而言，观察到TNF-α -308G/A的脓毒症风险增加（GA与GG相比：OR = 1.43，95%CI：1.07 - 1.92；GA/AA与GG相比：OR = 1.42，95%CI：1.06 - 1.89）。亚组分析显示，在亚洲人群（GA与GG相比：OR = 1.63，95%CI：1.01 - 2.63）和成年患者中发现了显著关联。同样，在总体和亚组分析中均观察到TNF-α -238G/A的脓毒症风险增加。然而，未发现TNF-α -308G/A和-238G/A基因多态性与脓毒症相关死亡率之间存在显著关联。这些发现表明，TNF-α -308G/A和-238G/A基因多态性均与脓毒症风险增加相关，但与脓毒症相关死亡率无关。需要进一步开展更大样本量的研究来证实这些结果。
