Ⅰ型胶原α1 Sp1多态性与骨密度和骨折关联性的Meta分析

Association of collagen type I alpha1 Sp1 polymorphism with bone mineral density and fracture: a Meta-analysis of case-control studies

背景:到目前为止,多项研究已经对Sp1多态性对骨质疏松和骨折的风险做出了评估。有报道称这种多态性与骨密度降低和骨折有密切联系,但也有研究称未发现类似联系,这些结果导致了很大的争议。目的:通过仅纳入病例对照研究的Meta分析来评价Ⅰ型胶原α1 Sp1多态性对骨密度和骨折的影响。方法:检索MEDLINE,EMBASE,Pub Med数据库有关Ⅰ型胶原α1 Sp1对骨密度和骨折影响的病例对照研究,计算合并效应值比值比(ORs)及其95%可信区间(95%CI)。并对异质性和偏倚进行评估。结果与结论:共32篇文献符合纳入标准。其中有22项研究评价了Sp1多态性对骨折的影响,在5个基因模型中均可发现Sp1多态性与骨折危险性有关联,但在亚组分析中,仅在欧洲人群有类似结果。有13项研究评价了Sp1多态性对骨密度降低的影响,结果发现Sp1与骨密度降低有密切关系,亚组分析在欧洲和美洲人群中有类似结果,但是在亚洲人群中并无类似发现。总体来说,Ⅰ型胶原α1 Sp1多态性是骨折和骨密度降低的危险因素,但也存在地区即地理性差异性。

BACKGROUND： Currently, there are large numbers of studies related to the association between collagen type Ⅰ alpha1 （COL1A1） Sp1 polymorphism and bone mineral density and fracture risk, but the results are inconsistent. OBJECTIVE： To evaluate the impact of the COL1A1 Sp1 polymorphism on bone mineral density and fracture by using the Meta-analysis.METHODS： We comprehensively searched the eligible studies for the present meta-analysis through MEDLINE, PubMed, EMBASE databases. Pooled odds ratios and 95% confidence intervals of Sp1 polymorphisms for bone mineral density and fracture risk were obtained, with attention to study quality and publication bias. RESULTS AND CONCLUSION： A total of 32 studies met the inclusion criteria, among which, 22 studies evaluated the Sp1 polymorphism and fracture risk. Significant associations were found in five genetic models. In the stratified analysis by region, the same results were found in the Europeans but not Americans and Asians. Thirteen studies evaluated the Sp1 polymorphism and low bone mineral density risk. A similar result was obtained However, the analysis of bone mineral density data showed an increased relation between Sp1 polymorphism and low bone mineral density in Europeans and Americans but not in Asians. Overall, the current meta-analysis concludes that the COL1A1 Sp1 polymorphism is associated with low bone mineral density and fracture risk, especially in Europeans. However, susceptibility to them varies markedly among populations from different regions.