Zhang Yu, Xie Hui, Zhao Dewei, Wang Benjie, Yang Lei, Meng Qingyu
Department of Orthopedics, Dalian University Affiliated Zhongshan Hospital, Dalian, Liaoning, China.
Medicine (Baltimore). 2017 May;96(20):e6049. doi: 10.1097/MD.0000000000006049.
The exploration for the etiology of osteonecrosis of the femoral head (ONFH) has got some promising findings, but the morbidity of ONFH is still not under control. The C3435T polymorphism of ATP-binding cassette subfamily B member 1 (ABCB1) gene has been reported to possess significant influence on ONFH onset, but relevant outcomes remain conflicting rather than conclusive. Therefore, a meta-analysis was useful to pool these results together for a more reliable conclusion.
The association of ABCB1 C3435T polymorphism with ONFH susceptibility was estimated through calculated odds ratios (ORs) with their 95% confidence intervals (95% CIs). The Q-test was applied for detecting inter-study heterogeneity, whereas sensitivity analysis for identifying any study owning substantial influence on pooled results. Begg's funnel plot and Egger's test were employed to examine publication bias across included studies.
ABCB1 C3435T polymorphism significantly decreased the risk of ONFH under TT vs CC (OR = 0.26, 95% CI = 0.13-0.50), TT+CT vs CC (OR = 0.72, 95% CI = 0.52-0.99), TT vs CC+CT (OR = 0.28, 95% CI = 0.15-0.52), and T vs C (OR = 0.64, 95% CI = 0.50-0.81) contrasts.
The variant C3435T in the ABCB1 gene may offer protection against the attack of ONFH, and more studies with larger sample sizes should be conducted to certify this issue.
股骨头坏死(ONFH)病因探索虽有一些有前景的发现,但ONFH发病率仍未得到控制。据报道,ATP结合盒亚家族B成员1(ABCB1)基因的C3435T多态性对ONFH发病有显著影响,但相关结果仍相互矛盾,尚无定论。因此,进行一项荟萃分析将这些结果汇总起来以得出更可靠的结论很有必要。
通过计算比值比(OR)及其95%置信区间(95%CI)来评估ABCB1 C3435T多态性与ONFH易感性的关联。采用Q检验检测研究间的异质性,同时进行敏感性分析以识别对汇总结果有重大影响的任何研究。采用Begg漏斗图和Egger检验来检查纳入研究中的发表偏倚。
在TT与CC(OR = 0.26,95%CI = 0.13 - 0.50)、TT + CT与CC(OR = 0.72,95%CI = 0.52 - 0.99)、TT与CC + CT(OR = 0.28,95%CI = 0.15 - 0.52)以及T与C(OR = 0.64,95%CI = 0.50 - 0.81)对比中,ABCB1 C3435T多态性显著降低了ONFH的风险。
ABCB1基因中的C3435T变异可能对ONFH的发作具有保护作用,应开展更多大样本研究来证实这一问题。