肺表面活性物质蛋白基因多态性与慢性阻塞性肺疾病易感性关联的Meta分析

Polymorphisms of Surfactant Protein Genes and Chronic Obstructive Pulmonary Disease Risk: A Meta-analysis

目的 探讨肺表面活性物质蛋白（SP）相关基因多态性与慢性阻塞性肺疾病（COPD）的关联。方法 检索万方数据、维普、Google学术、PubMed、CNKI、CBM、EMBASE、Web of Science等电子数据库，检索范围从建库至2013年9月，采用Stata 12.0进行Meta分析。结果 本研究共计纳入7项病例对照研究，包括1279例COPD患者和1482名健康对照人群。SP-A基因多态性与COPD易感性增加有关（等位基因模型OR=1.53,95%CI：1.14～2.05, P=0.005；显性模型OR=1.65,95%CI：1.02～2.69, P=0.043；隐性模型OR=1.66,95%CI：1.17～2.35, P=0.005；纯合子模型OR=2.06,95%CI：1.24～3.41, P=0.005；杂合子模型OR=1.59,95%CI：1.13～2.22, P=0.007），但SP-B和SP-D基因多态性均与COPD易感性关联无统计学意义（均P〉0.05）。亚组分析表明，SP-A基因多态性与亚洲人群COPD易感性增加关系密切，但与欧美人群无关。结论 SP-A基因多态性可能与亚洲人群COPD易感性增加有关。

Objective To evaluate the relationship between polymorphisms in surfactant protein （SP） genes and susceptibility to chronic obstructive pulmonary disease （COPD）. Methods An extensive literature search for relevant studies was conducted in databases of Wanfang Data, VIP, Google Scholar, PubMed, CNKI, CBM, EMBASE and Web of Science and so on from inception to Sep., 2013. A meta-analysis was then performed using Stata 12.0 software. Results 7 case-control studies were included with a total of 1,279 COPD cases and 1,482 healthy controls. This meta-analysis revealed that polymorphisms of the SP-A gene might be associated with an increased risk of COPD （allele model： OR=1.53, 95%CI： 1.14～2.05, P=0.005; dominant model： OR=1.65, 95%CI： 1.02～2.69, P=0.043; recessive model： OR=1.66, 95%CI：1.17～2.35, P=0.005：homozygous model：OR=2.06, 95%CI：1.24～3.41, P=0.005;heterozygous model：OR=1.59, 95%CI：1.13～2.22, P=0.007;respectively）. However, there was no evidence for any association between polymorphisms of the SP-B and SP-D genes and COPD risk （all P〉0.05）. Further subgroup analysis by ethnicity suggested that SP-A genetic polymorphisms were associated with an increased risk of COPD among Asians, but not among Caucasians. Conclusion SP-A genetic polymorphisms may contribute to increasing susceptibility to COPD, especially among Asians.