Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
Cytokine. 2018 Nov;111:278-286. doi: 10.1016/j.cyto.2018.09.002. Epub 2018 Sep 21.
Although two meta-analysis have reported no association between the tumor necrosis factor-α (TNF-α)-308G/A polymorphism and susceptibility to pre-eclampsia (PE), recent studies showed the association was still controversial. Thus, we conduct an updated meta-analysis to elucidate this association.
Studies related to TNF-α-308G/A and PE risk were retrieved from PubMed, the Web of Science, Embase, Cochrane Library, CNKI, Wanfang, CBM, VIP Database. The odds ratios (OR) and 95% confidence intervals (CIs) were calculated to estimate the association between the TNF-α-308G/A polymorphism and susceptibility to PE under the models of allelic contrast (A vs. G), recessive (AA vs. AG+GG), dominant (AA+AG vs. GG), and co-dominant (AA vs. GG).
22 studies (including 2459 cases and 4246 controls) were included in the meta-analysis. The overall analysis indicated that the significant association between TNF-α-308G/A polymorphism and susceptibility to pre-eclampsia existed in allele model (A vs. G: OR = 1.37, 95%CI: 1.06-1.77), but not in dominant model, recessive model, and co-dominant model. In subgroup analysis by ethnicity, pre-pregnancy BMI and pregnancy parity, the results showed the significant association between TNF-α-308G/A polymorphism and the risk of PE was obvious in Caucasian (A vs. G: OR = 1.36, 95%CI: 1.13-1.64; AA vs. GG: OR = 1.71, 95%CI: 1.03-2.86; AA+AG vs. GG: OR = 1.32, 95%CI: 1.03-1.71), Iranian (A vs. G: OR = 4.28, 95%CI: 2.01-9.11), and primipara (A vs. G: OR = 1.49, 95%CI: 1.15-1.92; AA vs. GG: OR = 2.15, 95%CI: 1.10-4.21).
Current evidence demonstrates that carriers of TNF-α (308A) allele would increase the susceptibility to PE, especially among Caucasian, Iranian and primipara.
尽管有两项荟萃分析报告称肿瘤坏死因子-α（TNF-α）-308G/A 多态性与先兆子痫（PE）易感性之间无关联，但最近的研究表明，这种关联仍存在争议。因此，我们进行了一项更新的荟萃分析以阐明这种关联。
从 PubMed、Web of Science、Embase、Cochrane Library、CNKI、万方、CBM 和 VIP 数据库中检索与 TNF-α-308G/A 和 PE 风险相关的研究。采用等位基因对比（A 与 G）、隐性（AA 与 AG+GG）、显性（AA+AG 与 GG）和共显性（AA 与 GG）模型，计算比值比（OR）和 95%置信区间（CI）来估计 TNF-α-308G/A 多态性与 PE 易感性之间的关联。
共有 22 项研究（包括 2459 例病例和 4246 例对照）纳入荟萃分析。总体分析表明，TNF-α-308G/A 多态性与先兆子痫易感性之间存在显著关联，在等位基因模型中（A 与 G：OR=1.37，95%CI：1.06-1.77），但在显性模型、隐性模型和共显性模型中不存在这种关联。按种族、孕前 BMI 和孕次亚组分析，结果显示 TNF-α-308G/A 多态性与 PE 风险之间的关联在高加索人（A 与 G：OR=1.36，95%CI：1.13-1.64；AA 与 GG：OR=1.71，95%CI：1.03-2.86；AA+AG 与 GG：OR=1.32，95%CI：1.03-1.71）、伊朗人（A 与 G：OR=4.28，95%CI：2.01-9.11）和初产妇（A 与 G：OR=1.49，95%CI：1.15-1.92；AA 与 GG：OR=2.15，95%CI：1.10-4.21）中更为明显。
目前的证据表明，TNF-α（308A）等位基因携带者会增加 PE 的易感性，尤其是在高加索人、伊朗人和初产妇中。
