中国人群ApoE基因多态性与2型糖尿病相关性的Meta分析

Association of ApoE gene polymorphisms and type 2 diabetes mellitus in Chinese population: a Meta-analysis study

目的运用循证医学的方法评价中国人群载脂蛋白E(ApoE)基因多态性与2型糖尿病(T2DM)的相关性。方法全面检索和筛选相关文献,按照循证医学原理对各研究结果进行数据合并,并评价其发表偏倚,运用敏感性分析评价结果的可靠性。结果检索到相关文献22篇,共4 452例。ApoE基因的等位基因E3和基因型E3/E3在各研究T2DM组和正常对照(NGT)组间存在异质性(P<0.01)。ApoE基因的等位基因E2和E4、基因型E2/E3和E3/E4在中国人群T2DM的分布频率显著高于NGT组,其合并OR值及95%CI分别为1.48(1.25,1.75)、1.26(1.08,1.47)、1.53(1.26,1.87)和1.32(1.10,1.58)(P<0.01);ApoE基因的等位基因E3和基因型E3/E3在中国人群T2DM的分布频率显著低于NGT组,其合并OR值及95%CI分别为0.72(0.62,0.83)和0.66(0.58,0.79)(P<0.01)。发表偏倚分析和敏感性分析结果显示Meta分析结果是稳定和可靠的。结论中国人群T2DM与ApoE基因多态性密切相关,ApoE等位基因E2和E4是T2DM的危险因子,基因型E3/E3则可能是T2DM的保护因子。

Objective To evaluate the correlation of apolipoprotein E（ApoE） gene polymorphisms and Type 2 diabetes mellitus（T2DM） in Chinese population by the method of evidence based medicine.Methods Relative literatures on Chinese population about T2DM vs normal glucose tolerance（NGT） were fully searched and screened through computed databases,such Wanfang and VIP,and Medline.The data were extracted for heterogeneity analysis.The Meta-analysis was employed for summarizing all the studies,calculating the pooled OR and its 95% confidence interval（95% CI）,and testing the overall effects.Both publication bias analysis by Egger＇s publication bias analysis and the fail-safe number for P=0.05（Nfs0.05）,and sensitivity analysis by different effect model and Hardy-Weinberg equilibrium（HWE） genetic principle were performed for evaluating the reliability and stability of the Meta-analysis.Results Twenty-two literatures,total 4 452 cases,were obtained.Remarkable heterogeneities were discovered in the allele E3 and genotype E3/E3 of ApoE between T2DM and NGT subjects in these studies（P0.10）.The allele E2,E4 and genotype E2/E3,E3/E4 of ApoE were more frequently in T2DM than NGT in Chinese population.Their ORs and 95%CIs were 1.48（1.25,1.75）,1.26（1.08,1.47）,1.53（1.26,1.87） and 1.32（1.10,1.58）,respectively（P0.01）.The allele E3 and genotype E3/E3 of ApoE were found less frequently in T2DM than NGT in these populations.Their ORs and 95%CIs were 0.72（0.62,0.83） and 0.66（0.58,0.79）,respectively（P0.01）.However,E2/E2,E2/E4 and E4/E4 of ApoE gene were no difference between T2DM and NGT subjects.The results of sensitivity analysis and publication bias analysis accounted for the reliability and stability of this Meta-analysis.Conclusion ApoE gene polymorphisms are associated with T2DM in Chinese populations.The allele E2 and E4 of ApoE are risk factors for T2DM,and the genotype E3/E3 is protective for T2DM.