Sun Xieyi, Gan Hua, Xia Yunfeng
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:
Ann Palliat Med. 2021 Jan;10(1):633-645. doi: 10.21037/apm-20-2585.
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.
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.
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).
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.
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。
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。
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）。
eNOS 4b/a的基因型多态性与DN密切相关。此外，DN肾间质患者中eNOS4bb的基因型分布频率低于非肾病糖尿病患者和正常对照组。
