5,10-亚甲基四氢叶酸还原酶C677T基因多态性与原因不明复发性流产关联的Meta分析  

The Association between Polymorphisms of 5,10-Methylenetetrahydrofolate Reductase Gene C677T and the Unexplained Recurrent Spontaneous Abortion: A Meta-analysis

作　　者：刘宇岩[1] 杨博逸[1] 李永芳[1] 卢响响[1] 王达[1] 孙贵范[1] 

机构地区：[1]中国医科大学公共卫生学院劳动卫生与环境卫生教研室,辽宁省沈阳市110001

出　　处：《中国全科医学》2013年第25期2992-2997,共6页Chinese General Practice

摘　　要：目的探讨5,10-亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性与原因不明复发性流产(URSA)之间的关联性。方法通过对万方、中国知网(CNKI)和Pubmed数据库进行相关已发表文献的检索,共查找出94篇文献,进一步按照既定的筛选标准进行筛选,最终将其中22篇文献纳入本次研究,进而针对MTHFR C677T基因多态性与URSA之间关联的病例对照研究进行Meta分析。结果对所有22篇文献中共包括URSA患者2 198人,正常对照2 612人进行统计合并后结果显示,基因型为TT和CT的女性其发生URSA的风险较基因型为CC者分别高93%和22%,即OR值分别为1.93〔95%CI(1.39,2.68)〕、1.22〔95%CI(0.99,1.50)〕;基因型为TT或CT的女性其发生URSA的风险较基因型为CC者高36%,即OR值为1.36〔95%CI(1.10,1.67)〕;T等位基因携带者发生URSA的风险较C等位基因携带者高34%,即OR值为1.34〔95%CI(1.14,1.58)〕。对所有9篇有关中国人群的文献进行统计合并后结果显示,基因型为TT和CT的女性其发生URSA的风险较基因型为CC者分别高267%和62%,即OR值分别为3.67〔95%CI(2.68,5.03)〕、1.62〔95%CI(1.29,2.05)〕;基因型为TT或CT的女性其发生URSA的风险较基因型为CC者高105%,即OR值为2.05〔95%CI(1.65,2.55)〕;T等位基因携带者发生URSA的风险较C等位基因携带者高89%,即OR值为1.89〔95%CI(1.64,2.18)〕。对13篇来自除中国以外的其他国家的文献进行统计合并后结果显示,各基因型的分布在URSA组和正常对照组之间的差异均无统计学意义(P>0.05)。结论在中国女性人群中,MTHFR C677T基因多态性与URSA的发生之间存在关联。而在除中国以外的其他国家中并未发现二者间存在关联。Objective To investigate whether polymorphisms of methylenetetrahydrofolate reductase （MTHFR） gene C677T is associated with the unexplained recurrent spontaneous abortion （URSA） . Methods Case - control studies on associa- tions between MTHFR C677T polymorphisms and the URSA published in Chinese and/or English language were searched for in Wanfang Database, CNKI, and Pubmed. Inclusion criteria were used to decide the articles finally included in the study. Meta - a- nalysis was conducted on these included studies. Results A total of 94 case - control studies on associations between MTHFR C677T polymorphisms and the URSA were searched out from the databases and 22 articles met the inclusion criteria involving 2 198 URSA patients and 2 612 controls. Women with TT and CT genotype had 93% and 22% higher risk of developing URSA than those with CC genotype, with OR value of 1.93 [95%CI （1.39, 2. 68） ] and 1.22 [95%CI （0. 99, 1.50） 3, respec- tively. Women with Tr or CT genotype had 36% higher risk of developing URSA than those with CC genotype, with OR value of 1.36 [ 95% CI （ 1.10, 1.67） 3 . T allele carriers had 34% higher risk of developing URSA than C allele carriers, with OR val- ue of 1.34 ~95% CI （ 1.14, 1.58） ] . Stratified analysis of nine studies involving only Chinese subjects showed that Chinese women with TT and CT genotype had 267% and 62% higher risk of developing URSA than those with CC genotype, with OR value of 3.67 [95%CI （2. 68, 5.03） 3 and 1.62 [95%CI （1, 29, 2. 05） 3, respectively. Chinese women with TI＂ or CT geno- type had 105% higher risk of developing URSA than those with CC genotype, with OR value of 2.05 [95% C1 （1.65, 2. 55） J. T allele carriers among Chinese women had 89% higher risk of developing URSA than C allele carriers, with OR value of 1.89 [ 95 % CI （ 1.64, 2. 18） 3 . The analysis of the other thirteen studies from other countries except China showed no signif- icant difference in genotype between the URSA group and the control group （ P

关 键 词：5 10-亚甲基四氢叶酸还原酶 多态性 原因不明复发性流产 META分析 

分 类 号：R714.21[医药卫生—妇产科学]