Shen Chang, Zhao Meng, Li Yun Yun, Liu Ning Pu
Beijing Tongren Eye Center & Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Chin Med Sci J. 2020 Mar 31;35(1):71-84. doi: 10.24920/003535.
Objective To investigate the association between the methylenetetrahydrofolate reductase gene C677T ( C677T) polymorphism and diabetic retinopathy (DR). Methods A total of 6971 subjects including 2707 DR patients and 4264 controls from 23 studies were enrolled in the study. A random-effects model was applied to estimate the overall effects and the stratified effects of the C677T polymorphism on the risk of DR, and study quality was also assessed. Results Strong associations were observed between the C677T polymorphism and DR. The carries of C677T were more likely to be found in the DR group in relative to the healthy control group with odds ratio 1.68, 2.55, and 2.31 respectively in allele contrast model (T C, 95%: 1.29-2.18, <0.001, =78.4%), homozygous model (TT CC, 95%: 1.70-3.83, =0.008, =54.4%) and dominant model (TT+CT . CC, 95%: 1.62-3.29, <0.001, =74.7%). This association can also be found in contrast to the Ncd (non-complicated diabetic mellitus) group (allele contrast, =1.50, 95%: 1.07-2.11, =0.032, =62.1%; homozygous, =2.39, 95%: 1.06-5.38, =0.017, =66.7%; dominant, =1.59, 95%: 0.97-2.62, =0.056, =56.5%). For the heterozygous model (CT CC), the association was significant in contrast to the healthy control group (=1.46, 95%: 1.64-3.69, =0, =77.3%), while in contrast to the Ncd control group the association was not statistically meaningful (=1.38, 95%: 0.87-2.18, =0.131, =43.7%). For the recessive model, 1.92-fold increased risk was found only in contrast to the Ncd control group (95%: 1.07-3.43, =0.064, =55.0%). There was no significant association found in the models in contrast to the DM control group. Conclusion In this meta-analysis, we found an association between the C677T polymorphism and DR, especially in contrast to the Ncd control group. Further studies are required to establish more definite relationship.
目的 探讨亚甲基四氢叶酸还原酶基因C677T多态性与糖尿病视网膜病变（DR）之间的关联。方法 本研究纳入了来自23项研究的6971名受试者，其中包括2707例DR患者和4264例对照。采用随机效应模型估计C677T多态性对DR风险的总体效应和分层效应，并对研究质量进行评估。结果 观察到C677T多态性与DR之间存在强关联。在等位基因对比模型（T vs C，95%：1.29 - 2.18，P<0.001，I² = 78.4%）、纯合子模型（TT vs CC，95%：1.70 - 3.83，P = 0.008，I² = 54.4%）和显性模型（TT + CT vs CC，95%：1.62 - 3.29，P<0.001，I² = 74.7%）中，DR组中C677T携带者的比例相对于健康对照组更高。与非糖尿病性视网膜病变（Ncd，非复杂性糖尿病）组相比也发现了这种关联（等位基因对比，OR = 1.50，95%：1.07 - 2.11，P = 0.032，I² = 62.1%；纯合子，OR = 2.39，95%：1.06 - 5.38，P = 0.017，I² = 66.7%；显性，OR = 1.59，95%：0.97 - 2.62，P = 0.056，I² = 56.5%）。对于杂合子模型（CT vs CC），与健康对照组相比关联显著（OR = 1.46，95%：1.64 - 3.69，P = 0，I² = 77.3%），而与Ncd对照组相比关联无统计学意义（OR = 1.38，95%：0.87 - 2.18，P = 0.131，I² = 43.7%）。对于隐性模型，仅与Ncd对照组相比发现风险增加1.92倍（95%：1.07 - 3.43，P = 0.064，I² = 55.0%）。与糖尿病对照组相比，各模型均未发现显著关联。结论 在这项荟萃分析中，我们发现C677T多态性与DR之间存在关联，尤其是与Ncd对照组相比。需要进一步研究以建立更明确的关系。
