肿瘤坏死因子-α-308G／A 基因多态性与支气管哮喘易感性关系的 Meta 分析

摘要

目的：系统评价肿瘤坏死因子（TNF）-α-308G／A 基因多态性与支气管哮喘患病风险的相关性。方法计算机检索 PubMed、EMbase、CNKI、WanFang Date、CBM和 VIP 数据库，查找有关 TNF-α-308G／A 基因多态性与支气管哮喘患病风险的病例-对照研究，检索时限均为从建库至2015年1月。由2位研究者按纳入及排除标准独立筛选文献、提取资料、评价质量，采用 RevMan 5．2和 Stata 12．0软件进行 Meta 分析。结果最终纳入14项研究，共计3418例支气管哮喘患者为病例组，2443例健康者为对照组。Meta 分析结果显示，与基因型 GG 比较，基因型 GA 和 GA ＋AA 可增加支气管哮喘发病风险（GA 与 GG：OR ＝1．32，95％CI：1．05～1．65，P ＝0．02；GA ＋AA 与 GG：OR＝1．37，95％CI：1．04～1．79，P ＝0．02）；基因型 AA 与支气管哮喘发病风险无相关性（AA 与 GG：OR＝0．95，95％CI：0．53～1．70，P ＝0．87）；与等位基因 G 比较，等位基因 A 可增加支气管哮喘发病风险（A 与 G：OR ＝1．27，95％CI：1．01～1．60，P ＝0．04）。人种亚组分析结果显示，在亚洲人群中， TNF-α基因多态性与支气管哮喘发病风险存在相关性（GA 与 GG：OR ＝1．36，95％CI：1．06～1．74， P ＝0．01）。然而年龄亚组分析结果显示，在成人和儿童中，TNF-α-308G／A 基因多态性与支气管哮喘发病风险无相关性。结论TNF-α-308G／A 基因多态性与支气管哮喘易感性相关，基因型 GA、GA ＋AA 以及等位基因 A 均可增加支气管哮喘发病风险。%Objective To systematically review the association between -308G/A polymorphism in tumor necrosis factor(TNF)-αgene and the susceptibility of bronchial asthma.Methods Case-control studies on the correlation TNF-α-308G/A gene polymorphism and the risk of bronchial asthma were searched in PubMed,EMbase,CNKI,WanFang Date,CBMand VIP from the date of their establishment to January 2015.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted date and assessed methodological quality.Meta-analysis was then conducted using RevMan5.2 and Stata12.0 software.Results A total of 14 studies involving 3 418 cases and 2 443 con-trol subjects were included.Meta-analysis showed that,compared with the genotype GG,genotype GA and GA +AA were associated with the susceptibility of bronchial asthma.GA vs GG(OR =1.32,95%CI:1.05 ~1.65,P =0.02);GA +AA vs GG(OR =1.37,95%CI:1.04 ~1.79,P =0.02);Genotype AA did not increase the risk of suffering from bronchial asthma,AA vs GG(OR =0.95,95%CI:0.53 ~1.70, P =0.87);Compared with the allele G,allele A increased the risk of bronchial asthma,A vs G(OR =1.27,95%CI:1.01 ~1.60,P =0.04).In the subgroup analysis by ethnicity,we found that there was significant association between them among Asian,GA vs GG(OR =1.36,95%CI:1.06 ~1.74,P =0.01). However,in stratification analysis by age,there was not significant association between them.Conclusion TNF-α-308G/A gene polymorphism is contributes to the susceptibility of bronchial asthma,and allele A, genotype GA and GA +AA are all increase the risk of bronchial asthma.