胆固醇7α-羟化酶基因——204A/C基因多态性与胆石病及血清脂质水平相关性的meta分析

A meta analysis of association between cholesterol 7α-hydroxylase-204A/C gene polymorphism and gallbladder stone with serum lipid levels

目的评价CYP7A1-204A/C基因多态性与胆石病风险及血清脂质水平之间的相关性。方法通过纳入排除标准,获取符合要求的文献;根据研究间的异质性,确定使用随机效应模型或固定效应模型,使用Rev Man对数据进行分析。结果使用5篇文献评估CYP7A1-204A/C基因多态性与胆石病风险间的关系,涉及病例组人群830名,对照组健康人群882名。结果显示,CYP7A1-204A等位基因导致GSD风险提高5%(OR=1.05,95%CI:0.91~1.22,P=0.48),提高幅度不显著。以种族进行的亚组分析后,仍未见显著差异。使用4篇文献对CYP7A1-204A与血清脂质水平的相关性进行分析,涉及病例组人群802名,健康对照组人群691名。所有对象均为亚洲人。数据整合结果显示,AC基因型比AA基因型人群TG水平更高,差异显著(MD=-0.42,95%CI=-0.76~0.08,P=0.01)。显示AC基因型比AA基因型人群TG水平更高,差异显著(MD=-0.42,95%CI=-0.76~0.08,P=0.01)。CC基因型病例组人群的LDL-C显著高于AA基因型病例组人群(MD=-0.40,95%CI=0.06~0.73,P=0.02);AA基因型比CC基因型对照组人群有着更高的TC水平(MD=-0.35,95%CI=-0.60~0.10,P=0.007);AC基因型对照组人群的TG水平高于CC基因型对照组人群,差异显著(MD=-0.35,95%CI=-0.61^-0.08,P=0.01);对比对照组人群的CC基因型,AA基因型人群的HDL-C水平更高(MD=-0.15,95%CI=-0.21~0.09,P=0.0000098)。结论 CYP7A1-204A/C多态性与GSD风险在亚洲人群中无相关性;但是,CYP7A1-204A/C多态性与血清脂质水平有显著相关性。

Objective To evaluate the influence of the 204A 〉 C polymorphism of CYP7A1 gene on the GSD and serum lipid levels. Methods According to inclusion/exclusion criteria, eligible studies on CYP7A1 gene-20gA C polymorphism of serum lipid levels and the risk of GSD were retrieved. Depending on the between-study heterogeneity, the fixed- or random-effects model was ap- plied, and the data were analyzed using the RevMan software. Results Five studies totaling 830 GSD patients and 882 healthy con- trois were used to evaluate the relation of CYP7A1-2OgA C polymorphism with GSD. Overall comparison of alleles A with C in all study population yielded 5% but non-significant increased risk of GSD （ OR = 1.05, 95% CI： O. 91 - 1.22, P =0. 48）. Subgroup analysis by ethnic differences did not show any association between CYP7A1-204A C polymorphism and GSD either. Four studies totaling 802 cases and 691 controls were used to assess the relation of CYPTA1-204A C polymorphism with serum lipid levels. All the subjects were from the Asian population. The pooled effects indicated that AC genotype had higher levels of TG than AA （MD = -0. 42, 95% CI： -0. 76 -0. 08, P = 0. 01 ）. CC genotype in cases had higher levels of TC （ MD = 0. 65, 95% CI： 0. 25 - 1.05, P = 0. 001 ） and LDL-C （MD =0.40, 95% CI： 0.06-0.73, P=0.02） than AA, AA（MD = -0.35, 95% CI： -0.60 -0. 10, P=0.007） andAC （MD =0. 35, 95% CI： -0. 61 -0. 08, P = 0. 01 ） genotypes in controls had higher levels of TC than CC, and AA genotype in con- trois had higher levels of HDL-C than CC（MD = -0. 15, 95% CI： -0. 21 - -0.09, P 〈0. 00001 ）. Conclusions The CYP7A1- 204A C polymorphism is significantly associated with serum lipid levels in Asian population, but not gallbladder stone disease.