内皮型一氧化氮合酶4ba多态性对糖尿病肾病肾间质纤维化影响的荟萃分析。

A meta-analysis of the effects of endothelial nitric oxide synthase 4ba polymorphism on renal interstitial fibrosis in diabetic nephropathy.

作者信息

Sun Xieyi, Gan Hua, Xia Yunfeng

机构信息

Chongqing Medical University, Chongqing, China; Department of Nephrology, The People's Hospital of Rongchang District, Chongqing, China.

Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Email:

出版信息

Ann Palliat Med. 2021 Jan;10(1):633-645. doi: 10.21037/apm-20-2585.

DOI:10.21037/apm-20-2585

PMID:33545792

Abstract

BACKGROUND

This study aimed to investigate the relationship between endothelial nitric oxide synthase (eNOS) 4b/a gene polymorphism and renal interstitial fibrosis in patients with diabetic nephropathy (DN) via a meta-analysis, in the hope of providing guidance for the genotypic detection of DN.

METHODS

The Boolean logic search method was adopted. A literature search of PubMed, Medline, CNKI, and other databases from inception to June 2020 was performed using the search terms "eNOS 4b/a", "diabetes", "renal interstitial fibrosis", and "kidney disease". Literatures with a DN group, a non-nephropathy diabetic group, and a normal control group were screened. Review Manager software was employed to perform the meta-analysis.

RESULTS

A total of 13 articles were included in the meta-analysis, the majority of which had a low risk of bias (i.e., medium and high quality). The results of the meta-analysis indicated that the genotypic distribution frequency of eNOS4bb in patients with DN was significantly lower than that in the non-nephropathy diabetic group (Z=3.19, P=0.001). The genotypic distribution frequency of eNOS4aa was significantly higher in non-nephropathy diabetic patients than in the normal control group (Z=2.57, P=0.01). The genotypic distribution frequency of eNOS4ba was not statistically different between patients with DN and non-nephropathy diabetic patients (Z=1.45, P=0.15). The genotypic distribution frequency of eNOS4bb in DN patients was significantly lower than that in the normal control group (Z=3.03, P=0.002); however, the genotypic distribution frequency of eNOS4ba was significantly greater than that of the normal controls (Z=2.36, P=0.02), as was that of eNOS4aa (Z=2.34, P=0.02).

CONCLUSIONS

Genotypic polymorphism of eNOS 4b/a was closely related to DN. Moreover, the genotypic distribution frequency of eNOS4bb in DN renal interstitial patients was lower than that in non-nephropathy diabetic patients and normal controls.

摘要

背景

本研究旨在通过荟萃分析探讨内皮型一氧化氮合酶（eNOS）4b/a基因多态性与糖尿病肾病（DN）患者肾间质纤维化之间的关系，以期为DN的基因分型检测提供指导。

方法

采用布尔逻辑检索法。使用检索词“eNOS 4b/a”、“糖尿病”、“肾间质纤维化”和“肾脏疾病”，对PubMed、Medline、CNKI等数据库从建库至2020年6月进行文献检索。筛选出有DN组、非肾病糖尿病组和正常对照组的文献。采用Review Manager软件进行荟萃分析。

结果

荟萃分析共纳入13篇文章，其中大多数偏倚风险较低（即中高质量）。荟萃分析结果表明，DN患者中eNOS4bb的基因型分布频率显著低于非肾病糖尿病组（Z=3.19，P=0.001）。非肾病糖尿病患者中eNOS4aa的基因型分布频率显著高于正常对照组（Z=2.57，P=0.01）。DN患者与非肾病糖尿病患者之间eNOS4ba的基因型分布频率无统计学差异（Z=1.45，P=0.15）。DN患者中eNOS4bb的基因型分布频率显著低于正常对照组（Z=3.03，P=0.002）；然而，eNOS4ba的基因型分布频率显著高于正常对照组（Z=2.36，P=0.02），eNOS4aa的基因型分布频率也是如此（Z=2.34，P=0.02）。