多种基因多态性与≤60岁人群脑卒中关系的Meta分析

Correlation Between the Polymorphism of Multiple Genes and Stroke in Population Aged No More Than 60: A Meta-analysis

目的系统评价亚甲基四氢叶酸还原酶(MTHFR)C677T和A1298C、血管紧张素原(AGT)基因M235T、胱硫醚-β-合成酶(CBS)G919A、载脂蛋白E(Apo E)基因多态性与≤60岁人群脑卒中的关系。方法计算机检索Cochrane Library、Pub Med及中国知网、维普、万方数据库,收集与≤60岁人群脑卒中发生有关的基因多态性文献,检索时限均从建库至2014年1月。由2名研究者分别独立按照纳入与排除标准完成对文献的筛选、资料提取及质量评价,采用Rev Man 5.1软件进行Meta分析。结果本研究共纳入28项研究,包括1 840例患者(病例组)和2 525例对照(对照组)。Meta分析结果显示,分别有22、17项研究报告了MTHFR C677T基因CC、CT基因型频率与≤60岁人群脑卒中的关系,结果显示病例组和对照组CC、CT基因型频率间差异均有统计学意义〔OR=0.54,95%CI(0.39,0.78),P=0.000 5;OR=1.28,95%CI(1.07,1.54),P=0.007〕。4项研究报告了MTHFR A1298C基因多态性与≤60岁人群脑卒中的关系,结果显示两组AA、AC基因型频率间差异有统计学意义〔OR=0.54,95%CI(0.36,0.81),P=0.003;OR=1.68,95%CI(1.20,2.35),P=0.003〕。3项研究报告了Apo E基因多态性与≤60岁人群脑卒中的关系,相关基因型频率间差异均无统计学意义(P>0.05)。4项研究报告了G919A基因多态性与≤60岁人群脑卒中的关联,两组AA、AG和GG基因型频率间差异均无统计学意义(P>0.05)。结论本研究结果提示,关于MTHFR C677T基因多态性,CC基因型对≤60岁人群脑卒中的发病有一定保护作用,CT基因型是危险因素;关于MTHFR A1298C基因多态性,AA基因型对≤60岁人群脑卒中的发病有一定保护作用,AC基因型是危险因素。

Objective To investigate the relationship between the polymorphism of MTHFR C677 T and A1298 C gene,AGT M235 T gene, CBS G919 A gene, Apo E gene and stroke in population aged ≤ 60 years old. Methods We made a computer-based retrieval in Cochrane Library, Pub Med, CNKI, VIP and Wanfang, in search of literatures about the relationship between gene polymorphism and stroke in population aged ≤60 years old. The search time was set from database establishment to January 2014. According to inclusion and exclusion criteria, two researchers separately conducted literature screening,data extraction and quality evaluation. Rev Man 5. 1 software was employed to undertake the meta-analysis. Results A total of 28 independent researches were included,covering 1 840 patients（ case group） and 2 525 controls（ control group）.There were 22,17 researches that reported the correlation between MTHFR C677 T gene CC, CT genotype and stoke in population aged ≤60 years old respectively,and the Meta-analysis showed that case group and control group were significantly different in CC and CT genotype frequency 〔OR = 0. 54,95% CI（ 0. 39,0. 78）,P = 0. 000 5; OR = 1. 28,95% CI（ 1. 07,1. 54）,P = 0. 007 〕. There were 4 researches that reported the correlation between MTHFR A1298 C gene polymorphism and stroke in population aged ≤60 years old,and the Meta-analysis showed that case group and control group were significantly different in AA and AC genotype frequency 〔OR = 0. 54,95% CI（ 0. 36,0. 81）,P = 0. 003; OR = 1. 68,95% CI（ 1. 20,2. 35）,P = 0. 003 〕. There were 3 researches that reported the correlation between Apo E gene polymorphism and stroke inpopulation aged ≤60 years old,and the Meta-analysis showed no significant difference（ P〈0. 05） between the two groups in relevant gene frequency. There were 4 researches that reported the correlation between the G919 A gene polymorphism and stroke in population aged ≤60 years old,and there were no significant differences（ P〈0. 05） between the two groups in AA,AG and GG allele frequency. Conclusion For MTHFR C677 T gene polymorphism,CC gene has protective effect on the onset of stroke in population aged ≤ 60 years old, and CT gene is a risk factor; for MTHFR A1298 C gene polymorphism, AA gene has protective effect on the onset of stroke in population aged ≤60 years old,and AC gene is a risk factor.