HLA-G基因14bp插入/缺失多态性与子痫前期相关性的Meta分析

Association between 14 bp Insertion/Deletion Polymorphism of HLA-G Gene and Preeclampsia:A Meta-Analysis

目的系统评价HLA-G基因3’非编码区14 bp插入/缺失多态性与子痫前期的相关性。方法计算机检索PubMed、Web of Science、EMbase、CBM、CNKI、WanFang Data、VIP,收集2012年5月以前国内外公开发表的有关妊娠妇女及其配偶、后代HLA-G 14 bp插入/缺失多态性与子痫前期相关性的病例-对照研究。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用RevMan 5.1软件进行Meta分析。结果最终纳入10篇文献。Meta分析结果显示:子痫前期组父亲与子代的HLA-G+14 bp基因单倍型频率以及父亲+14 bp/+14 bp基因型频率明显高于正常对照组,子代HLA-G 14 bp基因单倍型频率低于正常妊娠组。其合并OR值及其95%CI分别为1.42(1.10,1.84)、1.54(1.25,1.90)、2.00(1.19,3.38)、0.67(0.54,0.82)。子痫前期组子代+14bp/+14 bp基因型频率明显高于正常对照组,14 bp/14 bp基因型频率明显低于正常对照组[OR=1.75,95%C(I1.11,2.77);OR=0.57,95%CI(0.41,0.81)]。子痫前期组,母(-14 bp/-14 bp)/子(-14 bp/-14 bp)基因型配伍频率显著低于正常妊娠组[OR=0.52;95%CI(0.31,0.85)],而母(+14 bp/-14 bp)/子(+14 bp/+14 bp)基因型配伍频率显著高于正常妊娠组[OR=3.77;95%CI(1.40,10.11)];父(-14 bp/-14 bp)/子(-14 bp/-14 bp)基因型配伍频率显著低于正常妊娠组[OR=0.33,95%CI(0.15,0.75)]。结论父亲和子代HLA-G 14 bp插入/缺失多态性与子痫前期存在相关性,母子基因型配伍分析可为子痫前期病因研究与临床诊治提供新线索。

Objective To systematically review the association between 14 bp insertion/deletion polymorphism of HLA-G gene and preeclampsia（PE）.Methods We electronically searched in the following databases：PubMed,Web of Science,EMbase,CBM,CNKI,WanFang Data,and VIP to collect all the case-control trials on the association between 14 bp insertion/deletion polymorphism of HLA-G gene and PE.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data and assessed the quality of the included studies.Then,meta-analysis was performed using RevMan 5.1 software.Results Totally 10 studies were recruited.The results of meta-analysis showed that,the preeclampsia group was higher than the control group in the frequencies of HLA-G ＋14 bp haplotype in the fetus and fathers and the frequencies of HLA-G ＋14 bp/＋14 bp genotype in fathers,but its frequencies of fetal HLA-G -14 bp haplotype was significantly lower.Their pooled OR and 95%CI were 1.42（1.10 to 1.84）,1.54（1.25 to 1.90）,2.00（1.19 to 3.38）,and 0.67（0.54 to 0.82）.Compared with the control group,in the preeclampsia group the frequencies of HLA-G ＋14 bp/＋14 bp genotype in fetus were higher,while the frequencies of HLA-G -14 bp/-14 bp genotype were lower（OR=1.75,95%CI 1.11 to 2.77;OR=0.57,95%CI 0.41 to 0.81）.In the preeclampsia group,the frequencies of mother（＋14 bp/-14 bp）/fetal（＋14 bp/＋14 bp） were higher than the control group（OR=3.77,95%CI 1.40 to 10.11）,while those of mother（-14 bp/-14 bp）/fetal（-14 bp/-14 bp） and those of father（-14 bp/-14 bp）/fetal（-14 bp/-14 bp） were lower（OR=0.52,95%IC 0.31 to 0.85;OR=0.33,95%CI 0.15 to 0.75）.Conclusion Paternal and fetal 14 bp insertion/deletion polymorphism of HLA-G gene might be associated with preeclampsia.And maternal-fetal genotype compatibility analysis might provide new clues for the pathogenesis research and clinical diagnosis of preeclampsia.