5-HT转运体基因启动子区多态性与便秘型肠易激综合征易感性关系的meta分析

Correlation of Serotonin Transporter Gene-linked Polymorphic Region Polymorphism with Constipationpredominant Irritable Bowel Syndrome:A Meta-analysis

背景：便秘型肠易激综合征（C-IBS）是一种常见的功能性肠病,国内外关于5-HT转运体基因启动子区（5-HTTLPR）多态性与C-IBS易感性关系的研究结果存在差异.目的：采用meta分析评价5-HTTLPR多态性与C-IBS易感性的关系.方法：计算机检索PubMed、Embase、Web of Science、CBM、CNKI和万方数据库,检索时限均从建库至2013年9月.选取国内外关于5-HTTLPR多态性与C-IBS发病风险关系的病例对照研究,按照纳入标准筛选文献、提取资料后,采用Stata 12.0软件行meta分析.结果：最终纳入14项研究,包括749例C-IBS患者和1 821名健康对照,STREGA质量评分为5～6分.Meta分析显示5-HTTLPR多态性与C-IBS发病风险相关（L vs.S：OR=1.21,95％ CI：1.03～1.47; LL vs.SS：OR=1.57,95％ CI：1.08～2.29; LL vs.LS：OR=1.68,95％ CI：1.12～2.54;LL vs.LS＋SS：OR=1.59,95％ CI：1.14～2.23）.亚组分析显示,高加索人群中L vs.S（OR=1.27,95％CI：1.04～1.54）、LL vs.SS（OR=1.58,95％ CI：1.06～2.37）、LL vs.LS＋SS（OR=1.36,95％ CI：1.01～ 1.82）遗传模型与C-IBS发病风险存在相关性,而亚洲人群中5-HTTLPR多态性与C-IBS发病无关.结论：基于本研究结果,5-HTTLPR多态性与C-IBS易感性的关系存在人种差异,在高加索人群中,携带L等位基因和LL基因型可能是C-IBS易感的危险因素,但上述结论仍需进一步验证.

Background： Constipation-predominant irritable bowel syndrome （C-IBS） is a commonly seen functional bowel disease. Studies on the correlation of serotonin transporter gene-linked polymorphic region （5-HTTLPR） polymorphism with C-IBS are still controversial. Aims： To evaluate the correlation of 5-HTTLPR polymorphism with C-IBS by meta-analysis. Methods： Case-control studies on correlation of 5-HTI＇LPR polymorphism with C-IBS were retrieved by searching PubMed, Embase, Web of Science, CBM, CNKI and Wanfang Database from inception to September 2013. Data of accepted articles in accordance with inclusion criteria were extracted and meta-analysis was performed by using Stata 12.0 software. Results： A total of 14 studies involving 749 eases of C-IBS and 1 821 controls were included, STREGA score was between 5 and 6. Meta-analysis showed that 5-HTTLPR polymorphism was correlated with the risk of C-IBS （L vs. S： OR = 1.21, 95% CI： 1.03-1.47; LLvs. SS： OR=1.57, 95% CI： 1.08-2.29; LLvs. LS： OR=1.68, 95% CI： 1.12-2.54; LL vs. LS ＋ SS： OR = 1.59, 95% CI： 1.14-2.23）. Subgroup analysis revealed that L vs. S （ OR = 1.27, 95% CI： 1.04- 1.54）, LLvs. SS （OR = 1.58, 95% CI： 1.06-2.37）, LL vs. LS ＋SS （OR =1.36, 95% CI： 1.01-1.82） in Caucasians were significantly correlated with risk of C-IBS, however, 5-HTTLPR polymorphism in Asians was not correlated with C-IBS risk. Conclusions： 5-HTTLPR polymorphism may play a role in the susceptibility of C-IBS in an ethnicity specific manner. The Caucasians who carry L allele and LL genotype tend to face an increasing risk of C-IBS, but this conclusion needs to be proved by further studies.