摘要
目的系统评价中国人细胞毒性T淋巴细胞相关抗原4(cytotoxic T lymphocytes associated antigen-4,CTLA-4)基因第一外显子49位点A/G、启动子-318位点C/T多态性与Graves病(Graves’ disease,GD)的相关性。方法计算机检索CNKI、VIP、CBM、PubMed、EMbase以及The Cochrane Library数据库,收集国内外关于中国人群CTLA-4基因第一外显子49位点A/G、启动子-318位点C/T多态性与GD相关性的病例-对照研究。检索时限均从1980年1月至2011年12月。按纳入和排除标准筛选文献、提取资料和评价质量后,采用RevMan 5.0和STATA 12.0软件进行Meta分析。结果①中国人群CTLA-4第一外显子49位点A/G多态性的系统评价共纳入10个研究。Meta分析结果显示:具有基因型G/G的中国人群发生GD的风险高于具有基因型A/A[OR=3.38,95%CI(2.07,5.51)]和基因型A/G[OR=1.72,95%CI(1.31,2.25)]的中国人群。同时,等位基因G引起GD的发病风险高于等位基因A[OR=1.87,95%CI(1.44,2.41)]。②中国人群CTLA-4启动子-318位点C/T多态性的系统评价共纳入5个研究。Meta分析结果显示:在GD发病风险方面,具有基因型T/T的中国人群与具有基因型C/C[OR=0.75,95%CI(0.26,2.12)]和基因型C/T[OR=0.92,95%CI(0.31,2.73)]的中国人群相当。同时,等位基因T引起GD的发病风险与等位基因C相当[OR=0.83,95%CI(0.61,1.12)]。结论现有研究的Meta分析结果显示,中国人群CTLA-4基因第一外显子49位点等位基因G与GD发病有关,但尚未发现启动子-318位点等位基因及基因型与GD发病相关。由于受纳入研究的质量和数量所限,上述结论尚需更多高质量的研究加以验证。
Objective To systematically evaluate correlation between exon-1 （locus 49, A/G） and promoter （locus -318, C/T） polymorphisms of Chinese population cytotoxic T lymphocytes associated antigen-4 （CTLA-4） gene and Graves＇ Disease （GD）. Methods Relevant studies were electronically searched in CNKI, VIP, CBM, PubMed, EMbase and The Cochrane Library from 1980.1 to 2011.12. According to the inclusion and exclusion criteria, we selected and screened all case-control studies on the correlation between CTLA-4 exon -1 （locus 49, A/G） and promoter （locus -318, C/T） polymor- phisms of Chinese population and GD. Then we extracted the data and assessed the methodological quality of the included studies. Meta-analysis was performed using RevMan 5.0 and STATA 12.0 software. Results （1） Ten studies on exon-1 were included. Results of meta-analyses showed that Chinese population with genotype G/G had a higher GD risk than those with genotype A/A （OR=3.38, 95%CI 2.07 to 5.51） and A/G （OR=1.72, 95%CI 1.31 to 2.25）. Also, the allele G showed significant association with increased GD risk compared to the allele A （OR=1.87, 95%CI 1.44 to 2.41）. （2） Five studies on promoter-318 were included. Results of meta-analyses showed that Chinese population with genotype T/T presented no increased relative risk compared to those with genotype C/C （OR=0.75, 95%CI 0.26 to 2.12） or C/T （OR=0.92, 95%CI 0.31 to 2.73）. Meanwhile, the allele T showed no increased relative risk compared to the allele C （OR=0.83, 95%CI 0.61 to 1.12）. Conclusion The al- lele G at the locus 49 of exon -1 of Chinese population is significantly associated with increased GD risks, yet the correlation between promoter -318 C/T polymorphism and GD hasn＇t been demonstrated. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to test the above conclusion.
出处
《中国循证医学杂志》
CSCD
2012年第11期1302-1308,共7页
Chinese Journal of Evidence-based Medicine
