Yang Yujiao, Wu Wenhui, Wang Long, Ding Yi
Department of Geriatrics Department of Hemodialysis, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Medicine (Baltimore). 2018 Aug;97(31):e11750. doi: 10.1097/MD.0000000000011750.
The results of published studies which examined the association between variable number tandem repeat (VNTR) polymorphism of interleukin-1 receptor antagonist (IL-1RN) and ischemic stroke (IS) are conflicting. Thus, we performed a meta-analysis to examine the potential association between IL-1RN VNTR polymorphism and IS risk.
A systematic literature search of PubMed, Embase, Medline, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, CQVIP, and WANFANG Database identified 10 studies with 2331 cases and 3335 controls. The pooled odds ratio (OR) with 95% confidence interval (95% CI) was calculated to evaluate the strength of the association. Subgroup analysis and meta-regression analysis were used to investigate the potential sources of heterogeneity. Begg funnel plots were used to explore the publication bias.
In this study, no enough proof was found to prove the association between IL-1RN 86-bp VNTR polymorphism and IS risk with random-effects model in the homozygous model (1/1 vs 2/2, OR = 0.97, 95% CI = 0.50-1.87, Pheterogeneity = .00), the heterozygous model (1/2 vs 2/2, OR = 0.64, 95% CI = 0.41-1.01, Pheterogeneity = .10), the dominant model (1/1 + 1/2 vs 2/2, OR = 0.85, 95% CI = 0.51-1.42, Pheterogeneity = .02), the recessive model (1/1 vs 1/2 + 2/2, OR = 0.69, 95% CI = 0.46-1.03, Pheterogeneity = .00), and allelic model (1 vs 2, OR = 1.24, 95% CI = 0.89-1.74, Pheterogeneity = .00). A marginally significant negative association was observed between IL-1RN 86-bp VNTR polymorphism and IS risk in the heterozygous model in the fixed-effects model (1/2 vs 2/2, OR = 0.71, 95% CI = 0.53-0.95, Pheterogeneity = .10). In subgroup analyses, similar association was found in the group whose control size was lower than 300.
In conclusion, our results suggested that there was no sufficient evidence to support the association between IL-1RN 86-bp VNTR polymorphism and IS. Further large epidemiologic studies need to be done to confirm these findings.
已发表的研究探讨白细胞介素-1受体拮抗剂（IL-1RN）可变数目串联重复序列（VNTR）多态性与缺血性卒中（IS）之间关联的结果相互矛盾。因此，我们进行了一项荟萃分析，以研究IL-1RN VNTR多态性与IS风险之间的潜在关联。
通过对PubMed、Embase、Medline、Web of Science、Cochrane图书馆、中国生物医学文献数据库、中国知网、维普资讯和万方数据库进行系统的文献检索，确定了10项研究，共2331例病例和3335例对照。计算合并比值比（OR）及95%置信区间（95%CI）以评估关联强度。采用亚组分析和荟萃回归分析来探究异质性的潜在来源。使用Begg漏斗图来探索发表偏倚。
在本研究中，未找到足够证据证明在纯合子模型（1/1 vs 2/2，OR = 0.97，95%CI = 0.50 - 1.87，P异质性 = 0.00）、杂合子模型（1/2 vs 2/2，OR = 0.64，95%CI = 0.41 - 1.01，P异质性 = 0.10）、显性模型（1/1 + 1/2 vs 2/2，OR = 0.85，95%CI = 0.51 - 1.42，P异质性 = 0.02）、隐性模型（1/1 vs 1/2 + 2/2，OR = 0.69，95%CI = 0.46 - 1.03，P异质性 = 0.00）以及等位基因模型（1 vs 2，OR = 1.24，95%CI = 0.89 - 1.74，P异质性 = 0.00）中，IL-1RN 86-bp VNTR多态性与IS风险之间存在关联（随机效应模型）。在固定效应模型的杂合子模型中（1/2 vs 2/2，OR = 0.71，95%CI = 0.53 - 0.95，P异质性 = 0.10），观察到IL-1RN 86-bp VNTR多态性与IS风险之间存在边缘显著的负相关。在亚组分析中，在对照组规模低于300的组中发现了类似的关联。
总之，我们的结果表明，没有足够证据支持IL-1RN 86-bp VNTR多态性与IS之间的关联。需要进一步开展大规模流行病学研究来证实这些发现。
