载脂蛋白C3基因SstⅠ多态性与冠心病及血浆甘油三酯水平关联性的Meta分析

Meta-analysis on the Association of ApoC3 SstⅠ Polymorphism with Coronary Heart Disease and Plasma Triglyceride Levels

目的系统评价载脂蛋白C3（ApoC3）基因SstⅠ多态性与冠心病（CHD）及血浆甘油三酯（TG）水平的关联性。方法检索国内外相关数据库以获取所有公开发表的以探索ApoC3 SstⅠ多态性与CHD关联性的文献,截止时间2014年3月。根据纳入标准提取合格文献进行系统评价,采用显性、隐性和纯合子遗传模型进行分析。从纳入的文献中提取ApoC3 SstⅠ多态性不同基因型参试者的血浆TG浓度数据并采用显性模型分析。根据异质性检验结果选择固定或随机效应模型进行数据合并,并采用Begg’s检验评价发表偏倚。结果共纳入32篇文献,包括病例5298例,对照7405名;其中15篇文献给出了不同基因型的血浆TG浓度数据。在显性、隐性和纯合子遗传模式下,ApoC3 SstⅠ多态性与CHD的关联性有统计学意义（显性模型：OR=1.32,95%CI 1.10~1.59;隐性模型：OR=1.36,95%CI 1.08~1.72;纯合子模型：OR=1.45,95%CI 1.14~1.84）。排除不符合Hardy-Weinberg平衡的文献后,在3种遗传模式下的分析结果与总体效应基本一致。按人群来源进行亚组分析,在以阿拉伯人为主的其他人群中,在3种遗传模式下ApoC3 SstⅠ多态性与CHD的关联性均有统计学意义;高加索人群在显性模式下差异有统计学意义。在显性模式下,ApoC3 SstⅠ多态性与血浆TG水平的关联性有统计学意义（SMD=0.26,95%CI0.16~0.36）。亚组分析表明,在健康人群（SMD=0.15,95%CI 0.05~0.26）和CHD群体（SMD=0.45,95%CI0.13~0.77）中ApoC3 SstⅠ多态性与血浆TG水平的关联性均有统计学意义。结论 ApoC3基因SstⅠ多态性与CHD遗传易感及血浆TG水平关联,需开展更多高质量、大样本的随机对照试验加以确定。

Aim To investigate the association of apolipoprotein C3（ApoC3） SstⅠ polymorphism with coronary heart disease（CHD） and plasma triglyceride levels by Meta-analysis.Methods The articles investigating the association between the ApoC3 SstⅠ polymorphism and CHD were searched from the Chinese and English electronic databases.The published time was up to March 2014.The qualities of the included studies were evaluated and the data were extracted to analyze the association between the ApoC3 SstⅠ polymorphism and CHD under the dominant,recessive and homozygote genetic models.Of the included articles,those that reported the triglyceride concentrations according to the ApoC3SstⅠ genotypes were taken out to analyze the association between the ApoC3 SstⅠ polymorphism and plasma triglyceride levels by dominant genetic model.Fix or random-effect model was used for data pooling based on the results of the heterogeneity tests.Publication bias was evaluated with the linear regression asymmetry Begg＇s tests.Results Thirty-two case-control studies containing 5298 cases of CHD and 7405 controls were included for the analysis of the ApoC3 tⅠ polymorphism and risk for CHD.Of the 32 articles,15 reported the plasma triglyceride levels by the ApoC3 SstⅠ polymorphism.The results showed that there was a significant association between the ApoC3 Sst Ⅰ polymorphism and CHD under the dominant model（OR = 1.32,95% CI 1.10 ~ 1.59）,recessive model（OR = 1.36,95% CI 1.08 ~ 1.72）and homozygote model（OR = 1.45,95% CI 1.14 ~ 1.84）.After excluding the studies not in Hardy-Weinberg equilibration,the analysis results were consistent with those including all studies under the three genetic models.When stratified according to ethnicity,the subgroup mainly with Arabian people had a significant association of ApoC3 SstⅠ polymorphism with CHD under the three models; the Caucasian population had a significant association under the dominant model.Regarding the association of the ApoC3 SstⅠ polymorphism with plasma triglyceride levels,a significant association（SMD = 0.26,95% CI 0.16 ~ 0.36） was observed under the dominant model.Subgroup analysis showed that the association between the ApoC3 SstⅠ polymorphism and plasma triglyceride levels was significant in both the healthy controls（SMD = 0.15,95% CI 0.05 ~ 0.26） and the CHD patients（SMD = 0.45,95% CI 0.13 ~ 0.77）.Conclusions ApoC3 SstⅠ polymorphism is associated with the risk for CHD and the elevation of plasma triglycerides.Further studies with high qualities and large samples are needed to validate the findings.