Tao Rongshan, Xiao Shujuan, Wang Lianping, Hu Chunjie, Suo Huiqin, Long Ruiyu, Liu Hangyu, Luo Wei, Hong Feng, Zhao Jingming, Li Qingjie
The Key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Public Health, Ministry of Education, Guizhou Medical University, Guiyang, China.
Xiangya School of Public Health, Central South University, Changsha, China.
Front Genet. 2024 Aug 20;15:1382957. doi: 10.3389/fgene.2024.1382957. eCollection 2024.
Tuberculosis (TB) is the leading cause of mortality worldwide. Previous studies have reported that TB susceptibility can be caused by vitamin D deficiency, which is affected by polymorphisms in the vitamin D receptor () gene. However, these results have been inconsistent. Therefore, we performed a meta-analysis to investigate the association between polymorphisms and TB susceptibility.
We systematically searched for relevant literature in PubMed, Embase, and Medline databases through December 31st, 2022. Inclusion and exclusion criteria were made to ensure that HIV-negative population is the targeted subjects. The pooled odds ratio () and 95% confidence interval () were then used to assess the strength of the association, and the quality of the included articles was evaluated using the Newcastle-Ottawa Scale. Potential sources of heterogeneity were evaluated based on subgroup and meta-regression analyses.
In our meta-analysis, we found that the FokI polymorphism in the gene was associated with increased TB susceptibility in the allele and recessive genotype models ( f vs. F = 1.235, 95%: 1.035-1.475; ff vs. Ff + FF = 1.317, 95%: 1.005-1.727. Further subgroup analysis based on ethnicity demonstrated the association with the risk of TB in all genotype models of the FokI polymorphism for Han population. Meta-regression analysis also indicated that ethnicity could be a potential source of heterogeneity in the FokI and BsmI polymorphisms in the gene. However, publication year was another source of heterogeneity for the I polymorphism.
In summary, the I polymorphism in the gene was found to increase the risk of TB in the HIV-negative population, both overall and in Asian populations. The findings presented in this paper could provide clues for preventing TB from the perspective of vitamin D supplementation, which is a controversial topic in the field of medicine and health.
结核病是全球主要的死亡原因。既往研究报道，维生素D缺乏可导致结核病易感性，而维生素D缺乏受维生素D受体（VDR）基因多态性影响。然而，这些结果并不一致。因此，我们进行了一项荟萃分析，以研究VDR基因多态性与结核病易感性之间的关联。
我们系统检索了截至2022年12月31日的PubMed、Embase和Medline数据库中的相关文献。制定了纳入和排除标准，以确保以HIV阴性人群为研究对象。然后使用合并比值比（OR）和95%置信区间（CI）来评估关联强度，并使用纽卡斯尔-渥太华量表评估纳入文章的质量。基于亚组分析和Meta回归分析评估潜在的异质性来源。
在我们的荟萃分析中，我们发现VDR基因中的FokI多态性在等位基因和隐性基因型模型中与结核病易感性增加相关（f vs. F = 1.235，95%CI：1.035 - 1.475；ff vs. Ff + FF = 1.317，95%CI：1.005 - 1.727）。基于种族的进一步亚组分析表明，FokI多态性的所有基因型模型在汉族人群中均与结核病风险相关。Meta回归分析还表明，种族可能是VDR基因中FokI和BsmI多态性异质性的潜在来源。然而，发表年份是I多态性异质性的另一个来源。
总之，发现VDR基因中的I多态性会增加HIV阴性人群总体以及亚洲人群患结核病的风险。本文的研究结果可为从补充维生素D的角度预防结核病提供线索，这在医疗卫生领域是一个有争议的话题。
