Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan.
College of Nursing, Augusta University, Augusta, GA 30912, USA.
Int J Environ Res Public Health. 2018 Jul 10;15(7):1453. doi: 10.3390/ijerph15071453.
Ischemic heart disease (IHD) is among the leading causes of death worldwide. polymorphisms have been associated with IHD risk, but the findings presented with heterogeneity. The purpose of the present meta-analysis was to provide an updated evaluation by integrating machine-learning based analytics to examine the potential source of heterogeneity on the associations between polymorphisms and the risk of various subtypes of IHD, as well as the possible impact of air pollution on polymorphisms and IHD risks. A comprehensive search of various databases was conducted to locate 123 studies (29,697 cases and 31,028 controls) for C677T, and 18 studies (7158 cases and 5482 controls) for A1298C. Overall, 677 polymorphisms were risks for IHD (TT: Risk ratio (RR) = 1.23, < 0.0001; CT: RR = 1.04, = 0.0028, and TT plus CT: RR = 1.09, < 0.0001). In contrast, 677 CC wildtype was protective against IHD (RR = 0.91, < 0.00001) for overall populations. Three countries with elevated IHD risks from C677T polymorphism with RR >2 included India, Turkey, and Tunisia. Meta-predictive analysis revealed that increased air pollution was associated with increased 677 TT and CT polymorphisms in both the case and control group ( < 0.05), with the trend of increased IHD risk resulting from increased air pollution. These results associate the potential inflammatory pathway with air pollution and the folate pathway with polymorphism. Future intervention studies can be designed to mitigate MTHFR enzyme deficiencies resulting from gene polymorphisms to prevent IHDs for at-risk populations.
缺血性心脏病（IHD）是全球主要死因之一。 多态性与 IHD 风险相关，但研究结果存在异质性。本荟萃分析的目的是通过整合基于机器学习的分析，提供更新的评估，以检查 多态性与各种亚型 IHD 风险之间关联的潜在异质性来源，以及空气污染对 多态性和 IHD 风险的可能影响。全面搜索了各种数据库，以确定 123 项研究（29697 例病例和 31028 例对照）用于 C677T，以及 18 项研究（7158 例病例和 5482 例对照）用于 A1298C。总体而言，677 多态性与 IHD 风险相关（TT：风险比（RR）=1.23， < 0.0001；CT：RR=1.04， =0.0028，和 TT 加 CT：RR=1.09， < 0.0001）。相比之下，677 野生型 CC 对整体人群的 IHD 具有保护作用（RR=0.91， < 0.00001）。来自 C677T 多态性的 IHD 风险升高的三个国家（RR>2）包括印度、土耳其和突尼斯。元预测分析显示，空气污染增加与病例组和对照组中 677 TT 和 CT 多态性增加有关（<0.05），空气污染增加导致 IHD 风险增加的趋势。这些结果将潜在的炎症途径与空气污染联系起来，将叶酸途径与 多态性联系起来。未来的干预研究可以设计为减轻由于基因多态性导致的 MTHFR 酶缺乏，以预防高危人群的 IHD。
