甲硫氨酸合成酶及其还原酶A2756G、G66A基因多态性与冠心病易感性的Meta分析

Associations of polymorphisms of methionine synthase A2756G and methionine synthase reductase G66A with the risks of coronary artery disease： a Meta-analysis

目的 探讨甲硫氨酸合成酶（methionine synthase,MTR）基因A2756G和甲硫氨酸合成酶还原酶（methionine synthase reductase,MTRR）基因G66A多态性与冠心病易感性的相关性.方法 系统检索Medline数据库中自1990年1月到2010年5月的英文相关文献及其引文,共获得14篇相关文献,纳入13篇.利用STATA软件及Meta程序对各研究结果 进行异质性检验和效应值合并分析.结果 纳入的13篇有效文献包括MTR A2756G基因多态性相关文献8篇,MTRR G66A基因多态性相关文献5篇.MTR A2756G基因多态性与冠心病易感性相关研究中,共有冠心病患者2143例,对照2270名（例）;MTRR G66A基因多态性与冠心病易感性相关研究中,共有冠心病患者811例,对照387名（例）.MTRR G66A基因多态性与冠心病易感性相关研究中,合并统计冠心病组总的GG基因型频数为246,AG基因型频数为397,AA基因型频数为168;对照组总的GG基因型频数为102,AG基因型频数为203,AA基因型频数为82;AG基因型与GG基因型相比,冠心病易感性降低27%,差异有统计学意义（OR=0.73,95%CI：0.54～0.99）;AA基因型与GG基因型相比,冠心病易感性降低,但差异无统计学意义（OR=0.84,95%CI：0.42～1.68）;将AG基因型和AA基因型合并后与GG基因型比较,冠心病易感性降低25%,差异有统计学意义（OR=0.75,95%CI：0.56～1.00）,且Egger检验未见明显发表偏倚（t=-0.19,P=0.862）.而各遗传模型下,MTR A2756G多态性与冠心病易感性均未见相关.结论 MTRR G66A位点基因多态性与冠心病易感性相关联,A等位基因携带者冠心病遗传易感性下降.

Objective To evaluate the associations between polymorphisms of methionine synthase （MTR） A2756G and methionine synthase reductase （MTRR） G66A and risk of coronary artery disease. Methods Literatures in Medline reporting the relationship between polymorphisms of MTR A2756G and MTRR G66A and risk of coronary artery disease from January 1990 to May 2010 were searched. A total of 14 relevant articles were selected and 13 of them met the criteria A Meta-analysis was performed to estimate the pooled odds ratio （OR） to evaluate the relationship between polymorphisms of MTR A2756G and MTRR G66A and risk of coronary artery disease. All analyses were performed using the STATA statistical software. Results Among the 13 studies,eight case-control studies containing 2143 cases of coronary artery disease and 2270 controls were included in the analysis of MTR A2756G and risk of coronary artery disease. Meanwhile,five case-control studies with 811 cases of coronary artery disease and 387 controls were included in the analysis of MTRR G66A and risk of coronary artery disease. In the analysis of MTRR G66A related to the risk of coronary artery disease,there were 246 GG carries,397 AG carriers and 168 AA carriers in the group of coronary artery disease,against 102 GG carriers,203 AG carriers and 82 AA carriers in the control group. Compared with the MTRR GG carriers, the risk of coronary artery disease decreased significantly by 27% （OR = 0. 73,95% CI： 0. 54 - 0. 99） and 25% （OR = 0. 75,95% CI ： 0. 56 -1.00） （Egger＇s test t = - 0. 19, P = 0. 862） in the MTRR 66 AG and AG/AA carriers, respectively, and also decreased in the MTRR AA carriers but significant difference was observed（OR = 0. 84,95% CI：0. 42 -1.68）. There was no significant association between coronary artery disease and MTR A2756G. Conclusion These results suggest that MTRR66 may play a role in coronary artery disease susceptibility. MTRR 66 A allele carries are associated with a statistically significant decreased risk of coronary artery disease susceptibility.