内皮型一氧化氮合酶(eNOS)基因a/b多态性与糖尿病视网膜病易感性的Meta分析

Association between eNOS Gene a/b Polymorphism and Diabetic Retinopathy Susceptibility: A Meta-analysis

目的系统评价内皮型一氧化氮合酶(eNOS)基因a/b多态性与糖尿病视网膜病易感性的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library(2015年第5期)、CBM、CNKI、VIP及WanFang Data数据库,搜集eNOS基因a/b多态性与糖尿病视网膜病易感性的病例-对照研究,检索时限均为建库至2015年5月。由2位评价者独立筛选文献、提取资料,并评价纳入研究的偏倚风险后,采用RevMan 5.2软件进行Meta分析。结果共纳入16个病例-对照研究,合计3 232例糖尿病视网膜病患者和3 555例对照人群。Meta分析结果显示:在总体分析中,eNOS基因a/b多态性与糖尿病视网膜病易感性无相关性[显性模型:OR=0.94,95%CI(0.78,1.15),P=0.57;隐性模型:OR=0.97,95%CI(0.78,1.22),P=0.82;aa vs.bb:OR=0.89,95%CI(0.71,1.12),P=0.32;ab vs.bb:OR=0.94,95%CI(0.77,1.14),P=0.52;a vs.b:OR=0.97,95%CI(0.82,1.14),P=0.70]。在按照种族进行的亚组分析中,eNOS基因a/b多态性与非洲人糖尿病视网膜病有相关性,但与亚洲人和白种人无相关性。结论 eNOS基因a/b多态性可能是非洲人糖尿病视网膜病的危险因子。

Objective To systematically evaluate the association between eNOS gene a/b polymorphism and diabetic retinopathy susceptibility. Methods PubMed, EMbase, The Cochrane Library（Issue 5, 2015）, CBM, CNKI,VIP and WanFang Data were systemically searched from inception to May 2015, to collect case-control studies about the eNOS a/b polymorphism and diabetic retinopathy susceptibility. Two reviewers independently screened literature,extracted data and evaluated the risk bias of included studies. Then, meta-analysis was performed by RevMan 5.2software. Results A total of 16 case-control studies were included, which involved 3 232 diabetic retinopathy cases and 3 555 controls. The results of meta-analysis showed that, in the total analysis, the a/b polymorphism of the eNOS gene was not associated with diabetic retinopathy risk（dominant model： OR=0.94, 95%CI 0.78 to 1.15, P=0.57;recessive model： OR=0.97, 95%CI 0.78 to 1.22, P=0.88; aa vs. bb： OR=0.89, 95%CI 0.71 to 1.12, P=0.32; ab vs. bb： OR=0.94, 95%CI 0.77 to 1.14, P=0.52; a vs. b： OR=0.97, 95%CI 0.82 to 1.14, P=0.70）; In the subgroup analysis by ethnicity,the a/b polymorphism was significantly associated with the risk of diabetic retinopathy in Africans, but not in Asians and Caucasians. Conclusion The a/b polymorphism in the eNOS gene may be a risk factor of diabetic retinopathy in Africans.