亚甲基四氢叶酸还原酶基因C677T多态性与先兆型偏头痛相关性的Meta分析  

Meta-analysis on the correlation between methylenetetrahydrofolate reductase gene C677T polymorphism and migraine with aura

作　　者：左彦方[1] 郭毅[2] 李明[1] 高展[1] 

机构地区：[1]深圳市龙岗中心医院神经内科,518116 [2]暨南大学第二临床医学院神经内科

出　　处：《临床神经病学杂志》2014年第5期338-341,共4页Journal of Clinical Neurology

基　　金：深圳市龙岗区科技发展基金(YS2013084)

摘　　要：目的 探讨亚甲基四氢叶酸还原酶（MTHFR）基因C677T多态性与先兆型偏头痛（MA）的相关性.方法 检索1994年1月～2013年3月MEDLINE、EBSCO、EMBASE数据库及PubMed,以及中国医院知识仓库中文期刊全文库、中国生物医学文献数据库、维普、万方等中文数据库中关于MTHFR基因C677T多态性与MA相关性的文献,按纳入、排除标准选择文献,并采用RevMan 5软件进行Meta分析.结果 共纳入18项病例对照研究,其中MA患者4276例,对照者27979例.各研究间具有很强的异质性（P＜0.05,I2=72％）,采用随机效应模型分析.Meta分析显示,MTHFR基因TT基因型发生MA的风险明显高于CT＋ CC基因型（OR=1.33,95％CI：1.02～1.75,P＜0.01）.剔除不符合H-W遗传平衡定律的3篇文献后,总的分析结果依然稳定（OR=1.39,95％ CI：1.02～ 1.88,P＜0.01）.在MA人群中所做种族分层分析结果显示,在地中海人种TT基因型增加了MA的发病风险,而在其他高加索人（包括北欧人种和印度雅利安人种）、芬兰人、土耳其人及日本人的研究并未显示出这种相关性.结论 MTHFR基因C677T多态性与MA相关,其TT基因型个体MA发病的风险增加.这在不同种族间存在一定差别.Objective To investigate the correlation between methylenetetrahydrofolate reductase （MTHFR） gene C677T polymorphism and migraine with aura （MA）.Methods The randomized controlled trials investigating the association between MTHFR C677T polymorphism and migraine with aura during Jan 1994 to Mar 2013 on MEDLINE,EBSCO,EMBASE,PubMed,CHKD,CBM,VIP database and Wan-Fang database were searched,then the data were picked up by inclusion and exclusion criteria.Meta-analysis was performed with RevMan version 5.Results There were 18 studies comprising 4276 MA cases and 27979 control subjects were included.There was very strong heterogeneity among these studies （P ＜ 0.05,I2 =72％）,and random-effect model was used.Meta-analysis showed that the risk of MA in patients with MTHFR gene TT genotype was significantly higher than that with CT ＋ CC genotype（OR =1.33,95％ CI：1.02-1.75,P ＜ 0.01）.Three studies not conformd to the H-W genetic laws of balance were eliminated.And then the result of Meta-analysis was still stable （OR =1.39,95％ CI：1.02-1.88,P ＜ 0.01）.Racial stratification analysis in MA patients showed that TT genotype could increase the risk of MA in Mediterranean race,while there was no correlation in the other Caucasian （including Nordic race and Indian Aryan race） and in the Finn,Turkish and Japanese.Conclusions MTHFR gene C677T polymorphism is associated with MA,the risk of MA in which with TT genotype is increased.Ethnicity may be another factor that plays a role in this association.

关 键 词：亚甲基四氢叶酸还原酶 C677T 基因 多态性 先兆型偏头痛 META分析 

分 类 号：R747.2[医药卫生—神经病学与精神病学]