亚甲基四氢叶酸还原酶C677T基因位点多态性与股骨头坏死关系的Meta分析

Association of methylenetetrahydrofolate reductase C677T polymorphism with femoral head necrosis: a meta-analysis

背景:关于亚甲基四氢叶酸还原酶基因C677T位是否为股骨头坏死易感基因存在争议。目的:系统评价亚甲基四氢叶酸还原酶基因C677T位点多态性与股骨头坏死发生的相关性。方法:计算机检索PubMed、Embase、the Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、维普和万方数据库中关于亚甲基四氢叶酸还原酶基因C677T位点的多态性与股骨头坏死发生关系的病例对照研究,检索时限均为建库截至2018年1月。按拟定的纳入标准和排除标准对原始文献进行筛选,对纳入研究进行文献质量评价和Meta分析。采用Stata 12.0软件进行异质性检验并计算各指标的OR值和95%CI,通过漏斗图、Egger回归试验评价发表偏倚。结果与结论:(1)6篇文献纳入研究,共1 174例患者,其中病例组包括395例股骨头坏死患者,对照组包括779位健康者;(2)Meta分析结果显示,亚甲基四氢叶酸还原酶C677T携带者(CC或CT型)与野生型患者(CC型)股骨头坏死发生率的关系:CT+TT vs.CC基因型[OR=1.43,95%CI (1.09-1.89),P=0.011];等位基因T vs.C [OR=1.46,95%CI (1.19-1.78),P=0.000];TT vs.CT基因型[OR=1.91,95%CI(1.28-2.86),P=0.002];TTvs.CC+CT基因型[OR=1.79,95%CI(1.29-2.50),P=0.001];(3)Egger回归结果未发现发表偏倚;(4)Meta分析显示,亚甲基四氢叶酸还原酶基因C677T位点多态性与股骨头坏死的发生相关。

BACKGROUND:Whether methylenetetrahydrofolate reductase(MTHFR)gene C677T is the susceptible gene of femoral head necrosis diseases remains controversial.OBJECTIVE:To evaluate the association of C677T polymorphism of MTHFR gene with the occurrence of femoral head necrosis.METHODS:A computer-based retrieval of PubMed,Embase,the Cochrane Library,Web of Science,CBM,CNKI,VIP and WanFang databases was conducted for the case-control trials concerning MTHFR gene C677T polymorphism and femoral head necrosis published before January 2018.According to the inclusion and exclusion criteria,the literature was screened,the quality of the included literature was assessed and meta-analysis was performed.Heterogeneity test was conducted on Stata 12.0 software,and the index values of each odd ratio(OR)and 95%confidence interval(CI)were calculated.The publication bias was evaluated by funnel plot and Egger regression test.RESULTS AND CONCLUSION:(1)Six articles involving 1 174 patients were enrolled,including 395 patients with femoral head necrosis and 779 healthy controls.(2)Meta-analysis results showed that the incidence of femoral head necrosis in MTHFR C677T carriers(CC or CT type)and wild-type patients(CC type)was related to the incidence of femoral head necrosis:CT+TT vs.CC genotype(OR=1.43,95%CI(1.09-1.89),P=0.011);T vs.C(OR=1.46,95%CI(1.19-1.78),P=0.000);TT vs.CT genotype(OR=1.91,95%CI(1.28-2.86),P=0.002);TT vs.CC+CT genotype(OR=1.79,95%CI(1.29-2.50),P=0.001).(3)Egger regression results showed no publication bias.(4)Meta-analysis results imply that the polymorphism of C677T in MTHFR gene was associated with the occurrence of femoral head necrosis.