Zhang Yongdong, Cao Yanhong, Xin Linlin, Gao Ningning, Liu Bingshuang
Department of Function, Xi'an Daxing Hospital, Xi'an, Shaanxi, China.
Medicine (Baltimore). 2018 Dec;97(50):e13386. doi: 10.1097/MD.0000000000013386.
Several published studies have investigated the association between the -308G/A (rs1800629) polymorphism in the tumor necrosis factor-α (TNF-α) gene and the risk of dilated cardiomyopathy (DCM). However, the TNF-α gene polymorphism has a controversial role in the pathogenesis of DCM among different populations. In the present study, a meta-analysis was performed to resolve this inconsistency.
Potentially eligible papers reporting an association between the TNF-α rs1800629 polymorphism and DCM susceptibility were searched in 4 databases including PubMed, EMBASE, Chinese Biomedical Database (CBM), and the Cochrane Library up to April 1, 2018. The odds ratio (OR) with its 95% confidence interval (CI) was used to estimate the strength of the associations. Subgroup analysis based on the ethnicity, studies with or without ischemic and valvular DCM was conducted. Publication bias detection was conducted using Begg test.
Nine papers detailing case-control studies were included, reporting a total of 1339 DCM cases and 1677 healthy controls. The meta-analysis results indicated that TNF-α rs1800629 was associated with increased DCM susceptibility in the populations studied under the heterozygous model (AG vs GG: OR = 1.91, 95% CI = 1.05-3.50, P = .035) and dominant model (AG + AA vs GG: OR = 1.87, 95% CI = 1.01-3.45, P = .046). In the subgroup analysis for ethnicity, rs1800629 polymorphism was significantly associated with the susceptibility of DCM for Asians under the 5 models (A vs G: OR = 2.87, 95% CI = 1.56-5.30, P = .001; AA vs GG: OR = 3.95, 95% CI = 1.13-13.82, P = 0.031; AG vs GG: OR = 3.8, 95% CI = 1.57-9.19, P = .003; AA vs GG + AG: OR = 2.51, 95% CI = 1.41-4.49, P = .002; AG + AA vs GG: OR = 3.77, 95% CI = 1.54-9.20, P = .004).
There may be a moderate association between TNF-α rs1800629 polymorphism and DCM susceptibility in the whole populations studied; however, TNF-α rs1800629 polymorphism was significantly associated with the susceptibility of DCM for Asians, which indicates that such associations may be different between ethnicities.
多项已发表的研究探讨了肿瘤坏死因子-α(TNF-α)基因-308G/A(rs1800629)多态性与扩张型心肌病(DCM)风险之间的关联。然而,TNF-α基因多态性在不同人群DCM发病机制中的作用存在争议。在本研究中,进行了一项荟萃分析以解决这一矛盾。
在包括PubMed、EMBASE、中国生物医学数据库(CBM)和Cochrane图书馆在内的4个数据库中检索截至2018年4月1日报道TNF-α rs1800629多态性与DCM易感性之间关联的潜在合格论文。采用比值比(OR)及其95%置信区间(CI)来估计关联强度。基于种族、有无缺血性和瓣膜性DCM的研究进行亚组分析。使用Begg检验进行发表偏倚检测。
纳入了9篇详细描述病例对照研究的论文,共报道1339例DCM病例和1677例健康对照。荟萃分析结果表明,在杂合模型(AG vs GG:OR = 1.91,95%CI = 1.05 - 3.50,P = 0.035)和显性模型(AG + AA vs GG:OR = 1.87,95%CI = 1.01 - 3.45,P = 0.046)下,TNF-α rs1800629与所研究人群中DCM易感性增加相关。在种族亚组分析中,rs1800629多态性在5种模型下与亚洲人DCM易感性显著相关(A vs G:OR = 2.87,95%CI = 1.56 - 5.30,P = 0.001;AA vs GG:OR = 3.95,95%CI = 1.13 - 13.82,P = 0.031;AG vs GG:OR = 3.8,95%CI = 1.57 - 9.19,P = 0.003;AA vs GG + AG:OR = 2.51,95%CI = 1.41 - 4.49,P = 0.002;AG + AA vs GG:OR = 3.77,95%CI = 1.54 - 9.20,P = 0.004)。
在所研究的总体人群中,TNF-α rs1800629多态性与DCM易感性之间可能存在中等程度的关联;然而,TNF-α rs1800629多态性与亚洲人DCM易感性显著相关,这表明不同种族之间这种关联可能存在差异。