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维生素 D 受体基因多态性与脊柱退行性疾病的关联:基于 35 项病例对照研究的荟萃分析证据。

Associations between vitamin D receptor gene polymorphisms and spinal degenerative disease: evidence from a meta-analysis based on 35 case-control studies.

机构信息

Department of Spine Surgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang 830054, China.

出版信息

Clin Neurol Neurosurg. 2021 Jan;200:106325. doi: 10.1016/j.clineuro.2020.106325. Epub 2020 Oct 23.

Abstract

OBJECTIVE

Dozens of reports on the associations of vitamin D receptor (VDR) gene polymorphisms and susceptibility to spinal degenerative disease (SDD) were conducted with inconsistent findings. This study aimed to elucidate the associations through a meta-analysis approach.

METHODS

Databases of PubMed, EMBASE, Web of Science, CNKI, and Wanfang were searched until July 10, 2020. Study quality was evaluated by using Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated to evaluate the associations under allelic model (1 vs. 2), homozygous model (11 vs. 22), heterozygous model (12 vs. 22), dominant model (11 + 12 vs. 22), and recessive model (11 vs. 12 + 22).

RESULTS

A total of 5021 cases and 5746 controls from 35 studies were eligible to this meta-analysis. According to NOS, the included studies were in excellent quality. In the overall population, the pooled data indicated that ApaI was associated with a reduced SDD susceptibility (AA vs. Aa + aa, OR = 0.83, 95%CI 0.71 - 0.96, P = 0.010). But the association was not observed in FokI, TaqI, and BsmI polymorphisms. Subgroup analysis suggested that TaqI polymorphism was correlated to an elevated SDD risk in Asians (TT + Tt vs. tt, OR = 2.55, 95%CI 1.90 - 3.44, P < 0.001).

CONCLUSION

The present study indicates that ApaI polymorphism may contribute to a reduced risk to SDD in the overall population, and TaqI polymorphism confers an elevated susceptibility to SDD in Asians. While, BsmI and FokI polymorphisms appear to have no significant association with SDD.

摘要

目的

有数十份关于维生素 D 受体(VDR)基因多态性与脊柱退行性疾病(SDD)易感性关联的报告,但研究结果并不一致。本研究旨在通过荟萃分析方法阐明其关联。

方法

检索PubMed、EMBASE、Web of Science、中国知网(CNKI)和万方数据库,检索时间截至 2020 年 7 月 10 日。使用纽卡斯尔-渥太华量表(NOS)评估研究质量。采用比值比(OR)及其 95%置信区间(95%CI)评估等位基因模型(1 对 2)、纯合子模型(11 对 22)、杂合子模型(12 对 22)、显性模型(11 + 12 对 22)和隐性模型(11 对 12 + 22)的关联。

结果

共有 35 项研究的 5021 例病例和 5746 例对照符合纳入标准。根据 NOS,纳入的研究质量很高。在总体人群中,汇总数据表明 ApaI 与 SDD 易感性降低相关(AA 对 Aa + aa,OR = 0.83,95%CI 0.71 - 0.96,P = 0.010)。然而,FokI、TaqI 和 BsmI 多态性与 SDD 之间没有观察到相关性。亚组分析表明,TaqI 多态性与亚洲人群 SDD 风险升高相关(TT + Tt 对 tt,OR = 2.55,95%CI 1.90 - 3.44,P < 0.001)。

结论

本研究表明,ApaI 多态性可能降低总体人群 SDD 的发病风险,而 TaqI 多态性使亚洲人群 SDD 的易感性升高。然而,BsmI 和 FokI 多态性与 SDD 似乎没有显著关联。

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