国人年龄相关性黄斑变性与补体因子H Y402H相关性研究的Meta分析

Systematic review and meta-analysis of the relationship between complementary factor H Y402H polymorphisms and age-related macular degeneration in China

目的:评价国人年龄相关性黄斑变性(AMD)与补体因子H(CFH)Y402H相关性。方法:计算机检索中国数字医院图书馆全文数据库、中国生物医学文献光盘数据库和MEDLINE(1995年1月～2008年10月),手工检索国内外相关教科书、杂志、会议论文等及其参考文献,所有研究对象均为中国人。两名评价者独立对纳入文献进行质量评价、提取资料。采用RevMan5进行Meta分析,并根据异质性检验结果采用相应模型进行合并。结果:10篇文献、共2459人符合纳入标准,均为高质量研究。Meta分析结果显示:等位基因频率C/T的比值比(OR)为2.39,95%可信区间(95%CI)为1.96～2.90,P<0.00001,表明在中国人中C基因型频率分布与AMD的关联有统计学意义,基因型CC和CT对基因型TT的OR值分别是5.49(95%CI3.20～9.45,P<0.00001)和1.91(95%CI1.47～2.50,P<0.00001)。结论:目前研究结果的Meta分析显示,CFH的单核苷酸多态性Y402H与AMD的发病率有明显的相关性,但从现有临床证据来看,还需高质量的随机对照试验来进一步验证、支持。

Objective： To evaluate the relationship between complementary factor H Y402H and agerelated macular degeneration （AMD）. Methods： We electronically searched www.chkd.enki.net and CBMdisk （1995.1-2008.10）, and a manual search in related textbooks, journals, congress articles and their references. All study subjects were ethnic Chinese. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta analysis was conducted by using RevMan 5 software.Method of Calculation of Summary Effect in Meta-analysis was chose by test for heterogeneity. Results： Ten literatures involving 2 459 patients were included, which are high methodological quality according to Jadad scale （the Jadad score ≥4）. Meta analysis indicated that high statistical significance was detected between CFH gene nucleotide polymorphysim Y402H and AMD with OR 2.39,95%CI 1.96-2.90, P〈0.000 01. The genotype effects for CC and TC versus TT genotypes （OR） were respectively 5.49 （95% CI 3.20-9.45, P〈0.000 01 ）, 1.91 （95% C1 1.47 -2.50, P〈0.000 01）. Conclusion： This Meta-analysis summarizes the strong evidence for an association between CFH gene nucleotide polymorphysim Y402H and AMD. More randomized controlled trial of high quality are needed for stronger evidence.