Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
Medical Department of Qingdao University, Qingdao, 266071, Shandong, China.
J Orthop Surg Res. 2021 Feb 19;16(1):146. doi: 10.1186/s13018-021-02269-w.
A great deal of evidence has supported that growth differentiation factor 5 (GDF5) is associated with the occurrence of knee osteoarthritis (KOA), while their results are not consistent. In the present study, we aimed to explore the association between GDF5 gene polymorphism and KOA for a more credible conclusion.
Comprehensive literature searches were carried out in English databases, including PubMed, Embase, Web of Science (WOS), and Cochrane, and Chinese databases, including China National Knowledge Infrastructure (CNKI), WANFANG, and VIP database. After the data were extracted from the required studies, the odds ratios (ORs) and their 95% confidence intervals (CIs) were determined to assess the correlation between GDF5 gene polymorphism and KOA. The publication bias was evaluated by funnel plot.
According to the inclusion and exclusion criteria, 15 studies on the correlation between GDF5 gene polymorphism and KOA occurrence were eligible for meta-analysis. Among these articles, four studies showed no apparent correlation, while the other 11 studies indicated an obvious correlation. Meanwhile, we also carried out a subgroup analysis of the population. Due to the inevitable heterogeneity, three genetic models were finally selected for analysis. With the allele model (C versus T: OR = 0.79, 95% CI = 0.730.87), recessive model (CC versus CT + TT: OR = 0.76, 95% CI = 0.680.86), and homozygous model (CC versus TT: OR = 0.66, 95% CI = 0.58~0.76), GDF5 gene polymorphism decreased the risk of KOA. Besides, a significant association was observed in Caucasians, Asians, and Africans. Meanwhile, the protective effect of genotype C (or CC) in the Asian group was little obvious than that in the Caucasian group and the African group. Although the quality of the included studies was above medium-quality, we obtained results with a low level of evidence.
The results of the meta-analysis showed that the genotype C (or CC) of GDF5 protected against KOA occurrence in Caucasian, Asian, and African populations.
大量证据表明生长分化因子 5(GDF5)与膝骨关节炎(KOA)的发生有关,但结果并不一致。本研究旨在探讨 GDF5 基因多态性与 KOA 的关系,得出更可信的结论。
在英文数据库(包括 PubMed、Embase、Web of Science(WOS)和 Cochrane)和中文数据库(包括中国知网、万方和维普数据库)中进行全面的文献检索。从所需研究中提取数据后,确定比值比(OR)及其 95%置信区间(CI),以评估 GDF5 基因多态性与 KOA 之间的相关性。通过漏斗图评估发表偏倚。
根据纳入和排除标准,有 15 项关于 GDF5 基因多态性与 KOA 发生相关性的研究符合荟萃分析的条件。这些文章中,有 4 项研究显示无明显相关性,而其余 11 项研究显示有明显相关性。同时,我们还对人群进行了亚组分析。由于存在不可避免的异质性,最终选择了三种遗传模型进行分析。在等位基因模型(C 对 T:OR=0.79,95%CI=0.730.87)、隐性模型(CC 对 CT+TT:OR=0.76,95%CI=0.680.86)和纯合子模型(CC 对 TT:OR=0.66,95%CI=0.58~0.76)中,GDF5 基因多态性降低了 KOA 的风险。此外,在白种人、亚洲人和非洲人中观察到显著相关性。同时,亚洲人群中基因型 C(或 CC)的保护作用比白种人群和非洲人群稍弱。虽然纳入研究的质量为中高质量,但我们得出的结果证据水平较低。
荟萃分析结果表明,GDF5 基因的 C 型(或 CC 型)在白种人、亚洲人和非洲人群中对 KOA 的发生具有保护作用。