中国人群1型糖尿病人类白细胞抗原-DR基因多态性的Meta分析

Meta-analysis on the HLA-DR gene polymorphisms of T1DM in Chinese populations

目的评价中国人群人类白细胞抗原(HLA)-DR基因多态性与T1DM的关联性。方法在T1DM病例组与健康对照组间比较HLA-DR基因位点的比值比(OR)。联合检索中华医学会系列期刊、CNKI数据库、中国科技期刊数据库和Pubmed获得全部相关文献,剔除不符合纳入标准的文献。应用Meta分析软件包REVMAN 5.0统计相关基因位点的OR值,同时评估发表偏倚。结果中国人群中,DR3、DR4、DRB1*0301和DRB1*0405是易感性基因(P均<0.05),总OR值分别为4.42、2.18、6.04和3.21。DR2、DR6、DR15和DRB1*1101是保护性基因(P<0.05),总OR值分别为0.31、0.50、0.51和0.35。危险基因型为DR3/DR4和DR3/DR9(P<0.05),总OR值分别为25.36和5.21。结论在中国人群中,一些与T1DM关联的HLA-DR与国外对其他国家人群的研究报道不尽相同。DR3、DR4、DRB1*0301、DRB1*0405、DR3/DR4和DR3/DR9在多个种族人群中均表现为易感性,与本研究一致;而DR2的保护性效应也与本研究结果较为一致,其余则差异有统计学意义。

Objective To evaluate the relationship between the allele polymorphism of HLA-DR and T1DM in the Chinese populations. Methods The odds ratios （OR） of HLA-DR allele distributions in T1DM patients were analyzed against healthy controls. All the relevant studies in Wanfang Data, CNKI, Chinese Science and Technology Periodical Database VIP Information, and Pubmed were identified, and poorly qualified studies were excluded. The meta-analysis software REVMAN 5.0 was applied for summarizing OR of relevant alleles in all the studies. The publication bias was also evaluated. Results DR3, DR4, DRB1 ＊ 0301, and DRB1 ＊ 0405 were the susceptible alleles （all P〈0. 05） in the Chinese populations,their merger OR were 4.42, 2.18, 6.04, and 3.21 respectively. DR2, DR6, DR15, and DRB1 ＊ 1101 were the protective alleles （P〈0. 05）, and their merger OR were 0. 31, 0.50, 0. 51, and 0. 35 respectively. DR3/DR4 and DR3/DR9 were also the susceptible genotypes （P〈0. 05）, and their merger OR were 25.36 and 5.21 respectively. Conclusion In the Chinese populations, some HLA-DR alleles relevant to T1DM are not totally the same as in the reports on non-Chinese populations. Susceptible alleles in China such as DR3, DR4, DRB1 ＊ 0301, DRB1 ＊ 0405, DR3/DR4, and DR3/DR9 match those of the non-Chinese populations, while the protective DR2 also agrees with the non-Chinese ones. And other alleles are quite different.