胰岛素基因可变重复序列多态性与PCOS发生风险相关性的Meta分析

Association between Polymorphism of Insulin Gene Variable Number Tandem Repeats and Polycystic Ovary Syndrome:A Meta-Analysis

目的系统评价胰岛素基因可变重复序列多态性与多囊卵巢综合征的相关性。方法收集公开发表的胰岛素基因可变重复序列多态性与多囊卵巢综合征关联的病例对照研究,按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用Rev Man 5.2软件进行Meta分析。结果最终纳入10篇文献。Meta分析结果显示:在总人群中,携带Ⅰ等位基因的个体相对于Ⅲ等位基因的个体,发生多囊卵巢综合征的风险下降18%[比值比(95%可信区间)=0.82(0.72,0.94),P=0.004];携带Ⅰ/Ⅰ基因型的个体发病风险低于Ⅰ/Ⅲ+Ⅲ/Ⅲ基因型的携带者[比值比(95%可信区间)=0.78(0.65,0.94),P=0.010]。亚组分析显示:携带Ⅰ等位基因的高加索人群发生多囊卵巢综合征的风险减少16%[比值比(95%可信区间)=0.84(0.73,0.98),P=0.023];隐性模型中(Ⅰ/Ⅰ+Ⅰ/Ⅲvs.Ⅲ/Ⅲ),亚洲人群的保护性作用更为显著[比值比(95%可信区间)=0.20(0.04,0.92),P=0.039],而高加索人群中未见显著性[比值比(95%可信区间)=0.84(0.64,1.09),P=0.185]。与Ⅲ/Ⅲ基因型携带者相比,携带Ⅰ/Ⅰ纯合子的亚洲人群发生多囊卵巢综合征风险下降79%[比值比(95%可信区间)=0.21(0.05,0.95),P=0.042],而高加索人群中的差异未见显著性[比值比(95%可信区间)=0.82(0.56,1.19),P=0.292]。结论胰岛素基因可变重复序列多态性与多囊卵巢综合征发生风险有关,但这种关联关系存在明显种族差异。

Objective The present meta-analysis aimed to investigate the association between the polymorphism ofinsulin gene variable number tandem repeats and polycystic ovary syndrome. Methods We collected all the case-controlstudies on the association between polymorphism of insulin gene variable number tandem repeats and polycystic ovarysyndrome. Meta- analysis was performed using Rev Man 5.2 software. Results 10 studies were recruited. In overallgroups,individuals who carried Ⅰ allele were associated with the 18% decreased risk of PCOS[OR（95% CI）= 0.82（0.72,0.94）,P=0.004]. Compared with those of Ⅰ/Ⅲ ＋ Ⅲ/Ⅲ genotypes,subjects with Ⅰ/Ⅰ genotype had lesssusceptibility to PCOS[OR（95%CI）= 0.78（0.65,0.94）,P=0.010]. Stratified analyses showed that the risk of PCOS inthe Caucasian population carrying Ⅰallele was reduced by 16%,compared with the carriers with Ⅲallele[OR（95%CI）=0.84（0.73,0.98）,P=0.023]. While in Recessive model and Homozygote model,Asian subgroup had the dominantprotective effect [OR（95% CI）=0.79（0.63,0.97）,P=0.028] and [OR（95% CI）=0.21（0.05,0.95）,P=0.042]respectively. Conclusion Polymorphism of insulin gene variable number tandem repeats was associated with the decreased risk of PCOS,but the associations were various in the different ethnical groups.