纤溶酶原激活物抑制剂-1 4G/5G多态性与复发性流产关联的系统评价和荟萃分析：更新版
Systematic review and meta-analysis of association between plasminogen activator inhibitor-1 4G/5G polymorphism and recurrent pregnancy loss: an update.
作者信息
Maghsudlu Mohaddese, Noroozi Zahra, Zokaei Elham, Motevaseli Elahe
机构信息
Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Thromb J. 2024 May 28;22(1):44. doi: 10.1186/s12959-024-00612-9.
BACKGROUND
We conducted this systematic review and meta-analysis to better understand the association between rs1799762 PAI-1 gene polymorphism and the risk of RPL.
METHODS
A systematic search for studies that assessed the association between PAI-1 4G/5G polymorphism and RPL risk published in search sources, PubMed/Medline, ISI Web of Knowledge, Scopus, and Google Scholar till January 2024 was conducted.
RESULTS
There were 23 case-control studies in total, with a high degree of statistical heterogeneity among them which indicated the need for subgroup analysis. We found a significant positive association between the risk of RPL and 4G/4G PAI-1 (OR: 2.57; 95% CI: 1.69-3.90), likewise 4G/5G (OR: 2/02 95% CI: 1.39-2.92) and mixed genotype (4G/4G+4G/5G) (OR: 2.31 95% CI: 1.81-2.93). Considering the ethnicity, the 4G/4G polymorphism is significantly associated with Asian descent (OR: 2.10; CI: 1.65-2.69) while the strong association (OR: 6.47; CI: 3.23-12.97) observed in the Greater Middle East descent is not statistically significant (P=0.16). PAI-1 4G/5G polymorphism association with RPL was only significant in Greater Middle East descent (OR: 2.93; CI: 2.41-3.56), and mixed genotype was significantly associated with RPL in Asian (OR: 2.37; CI: 1.55-3.61), Greater Middle East (OR: 3.01; CI: 2.16-4.19), and European populations (OR: 1.38; CI: 0.91-2.10). The association between RPL and PAI-1 4G/4G was significant for RPLs both under 12 weeks (OR: 1.82; 95% CI: 1.34-2.47), and under 24 weeks (OR: 1.46; 95% CI: 1.11-1.92), while considering heterozygote form the association was only significant for RPLs under 24 weeks (OR: 1.91; 95% CI: 1.58-2.31). Regarding the mixed genotype, there is a significant positive association between PAI-1 and RPL for RPLs under 12 weeks (OR: 2.09; 95% CI: 1.49-2.93), and under 24 weeks (OR: 2.10; 95% CI: 1.52-2.92).
CONCLUSIONS
Our findings indicate a significant association between the rs1799762 PAI-1 polymorphism and the risk of RPL.
背景
我们进行了这项系统评价和荟萃分析，以更好地了解纤溶酶原激活物抑制剂-1（PAI-1）基因rs1799762多态性与复发性流产（RPL）风险之间的关联。
方法
对截至2024年1月在PubMed/Medline、ISI Web of Knowledge、Scopus和谷歌学术等检索源上发表的评估PAI-1 4G/5G多态性与RPL风险之间关联的研究进行了系统检索。
结果
总共纳入了23项病例对照研究，它们之间存在高度的统计学异质性，这表明需要进行亚组分析。我们发现RPL风险与4G/4G型PAI-1之间存在显著正相关（比值比[OR]：2.57；95%置信区间[CI]：1.69 - 3.90），同样4G/5G型（OR：2.02；95% CI：1.39 - 2.92）以及混合基因型（4G/4G + 4G/5G）（OR：2.31；95% CI：1.81 - 2.93）也存在显著正相关。考虑种族因素，4G/4G多态性与亚洲人后裔显著相关（OR：2.10；CI：1.65 - 2.69），而在中东及周边地区后裔中观察到的强关联（OR：6.47；CI：3.23 - 12.97）无统计学意义（P = 0.16）。PAI-1 4G/5G多态性与RPL的关联仅在中东及周边地区后裔中显著（OR：2.93；CI：2.41 - 3.56），混合基因型在亚洲人（OR：2.37；CI：1.55 - 3.61）、中东及周边地区（OR：3.01；CI：2.16 - 4.19）和欧洲人群（OR：1.38；CI：0.91 - 2.10）中与RPL显著相关。RPL与PAI-1 4G/4G之间的关联在妊娠12周以内的RPL中显著（OR：1.82；95% CI：1.34 - 2.47），在妊娠24周以内的RPL中也显著（OR：1.46；95% CI：1.11 - 1.92），而考虑杂合子形式时，该关联仅在妊娠24周以内的RPL中显著（OR：1.91；95% CI：1.58 - 2.31）。对于混合基因型，PAI-1与妊娠12周以内的RPL之间存在显著正相关（OR：2.09；95% CI：1.49 - 2.93），在妊娠24周以内的RPL中也存在显著正相关（OR：2.10；95% CI：1.52 - 2.92）。
结论
我们的研究结果表明rs1799762 PAI-1多态性与RPL风险之间存在显著关联。
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