维生素D受体基因多态性与骨关节炎关系的Meta分析

Associations between vitamin D receptor gene polymorphisms and osteoarthritis: a meta-analysis

背景:维生素D受体与骨关节炎存在密切联系,而维生素D受体基因多态性被认为能够调控维生素D受体,进而影响骨关节炎的发生,但现有的研究仍存在争议。目的:确认维生素D受体基因多态性与骨关节炎的关系。方法:系统检索PubMed、Web of Science、EMbase、Cochrane Library、中国生物医学文献数据库、中国学术期刊全文数据库、万方、维普等数据库,检索时限均为建库截至2019年10月,检索所有提供了骨关节炎患者和非骨关节炎患者维生素D受体基因(ApaI、Bsm I、TaqI和Fok I)多态性数据的病例对照研究,采用Stata 14.0统计软件进行分析。结果与结论:①总共纳入21篇相关研究,共7 109例患者,其中包括骨关节炎患者3 123例,非骨关节炎患者4 006例;②Meta分析显示,欧洲人维生素D受体Bsm I多态性与骨关节炎之间存在相关性[(BB vs. bb:OR=1.677,95%CI(1.051,2.676),P=0.030;BB vs. Bb+bb:OR=1.780,95%CI(1.175,2.697),P=0.007],但只有3篇研究;亚洲人维生素D受体FokI多态性与骨关节炎之间存在相关性[(FF vs. Ff+ff:OR=0.609,95%CI(0.410,0.907),P=0.015],只有3篇研究;维生素D受体TaqI和ApaI多态性与骨关节炎无显著相关性,在排除异质性后结果也无明显相关性;③结果表明,维生素D受体ApaI、Bsm I、TaqI和FokI多态性可能与骨关节炎无明显相关性。

BACKGROUND: There is a close relationship between vitamin D receptor and osteoarthritis, and vitamin Dreceptor gene polymorphism is considered to be able to regulate vitamin D receptor, thus affecting the occurrence of osteoarthritis. However, the existing research is still controversial. OBJECTIVE: To identify the association between vitamin D receptor gene polymorphism and osteoarthritis. METHODS: A systematic search was conducted on Pub Med, Web of Science, EMbase, Cochrane Library, CBM, CNKI, Wanfang and VIP for studies published from inception to October 2019. All studies that provided vitamin D receptor(Apa I, Bsm I, Taq I, and Fok I) polymorphism data were retrieved. All statistical analyses were processed using Stata 14.0. RESULTS AND CONCLUSION:(1) Twenty-one articles involving 7 109 patients were enrolled, including 3 123 patients with osteoarthritis and 4 006 controls(non-osteoarthritis).(2) Meta-analysis results showed that there were associations between vitamin D receptor Bsm I polymorphisms and osteoarthritis in the Europe population [(BB vs. bb: OR=1.677, 95% CI(1.051, 2.676), P=0.030;BB vs. Bb+bb: OR=1.780, 95%CI(1.175, 2.697), P=0.007], but there were only three studies. There were associations between vitamin D receptor Fok I polymorphism and osteoarthritis in the Asian population [(FF vs. Ff+ff: OR=0.609, 95%CI(0.410, 0.907), P=0.015]. There were only three studies. There was no significant association between vitamin D receptor(Taq I and Apa I) polymorphism and osteoarthritis and no significant correlation between the results after exclusion of heterogeneity.(3) The meta-analysis results suggested that vitamin D receptor(Apa I, Bsm I,Taq I and Fok I) gene polymorphism might not be significantly correlated with osteoarthritis.