MTHFR基因多态性与糖尿病周围神经病发生风险的meta分析  

Risk of MTHFR Gene Polymorphism and Diabetic Peripheral Neuropathy: A Meta-Analysis

作　　者：薛飞肖 李琼阁 宁可 王威 王海峰 XUE Feixiao;LI Qiongge;NING Ke;WANG Wei;WANG Haifeng(Department of Clinical Laboratory,the Third Hospital of Xi’an,Xi’an 710018,China;Department of Pharmacy,Xi’an People’s Hospital/the Fourth Hospital of Xi’an,Xi’an 710004,China)

机构地区：[1]西安市第三医院检验科,西安710018 [2]西安市人民医院/西安市第四医院药剂科,西安710004

出　　处：《现代检验医学杂志》2023年第5期142-147,共6页Journal of Modern Laboratory Medicine

基　　金：陕西省科技厅重点研发计划项目(NO.2018SF-090):ApoE4基因引起内质网应激促tau蛋白磷酸化机制研究。

摘　　要：目的 分析亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因多态性与糖尿病周围神经病(diabetic peripheral neuropathy,DPN)发生风险的关系。方法 计算机检索PubMed,the Cochrane Library,Embase,中国知网和万方医学网数据库自建库~2021年11月发表的关于MTHFR C677T基因多态性与DPN相关的病例对照研究,采用纽卡斯尔-渥太华评价表(Newcastle-Ottawa Scale,NOS)评价文献质量。以比值比(odds ratio,OR)为效应指标,统计学分析采用RevMan5.3软件。结果 共纳入9项病例对照研究,包括751例病例组和854例对照组。Meta分析显示,T等位基因(R=1.54,95%CI:1.08~2.18)与DPN发生风险相关,差异有统计学意义(Z=2.41,P=0.02)。亚组分析显示,中国MTHFR C677T基因多态性与DPN发生风险相关(T vs C:OR=2.04,95%CI:1.21~3.44;TT vs CC:OR=3.90,95%CI:1.46~10.37;TC vs CC:OR=1.59,95%CI:1.05~2.40;TT+TC vs CC:OR=2.19,95%CI:1.03~4.66;CC+TC vs TT:OR=0.36,95%CI:0.19~0.68),差异有统计学意义(Z=2.68,2.72,2.21,2.03,3.12,均P<0.05)。土耳其TT基因型与DPN风险相关(TT vs CC:OR=3.58,95%CI:1.59~8.03;CC+TC vs TT:OR=0.31,95%CI:0.14~0.69),差异有统计学意义(Z=3.09,2.87,P=0.002,0.004)。伊朗CC+TC基因型与DPN风险增加有关(CC+TC vs TT:OR=2.84,95%CI:1.03~7.84),差异有统计学意义(Z=2.02,P=0.04)。德国、意大利MTHFR C677T基因多态性与DPN发病风险未见相关性,差异无统计学意义(Z=0.05~1.05,均P>0.05)。结论MTHFR C677T基因多态性与DPN发生风险可能与国家地区有关,检测该基因有助于中国、土耳其和伊朗人群DPN发病风险的预判,以期为临床诊疗提供参考。Objective To analyze the risk of methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms and diabetic peripheral neuropathy(DPN).Methods PubMed,the Cochrane Library,Embase,CNKI,Wanfang Medical databases were searched by computer to the case-control study on the correlation between MTHFR C677T gene polymorphism and DPN until November 2021.The quality of the literature was evaluated by Newcastle-Ottawa Scale(NOS).Statistical analysis was performed using RevMan5.33 and the odds ratio(OR)was used as the effect index.Results A total of 9 case-control studies were included,including 751 cases and 854.Meta-analysis showed that the T allele(OR=1.54,95%CI:1.08~2.18)was associated with the risk of DPN,and the difference was statistically significant(Z=2.41,P=0.02).Subgroup analysis showed that the polymorphism of MTHFR C677T gene was associated with the risk of DPN in China(T vs C:OR=2.04,95%CI:1.21~3.44,TT vs CC:OR=3.90,95%CI:1.46~10.37,TC vs CC:OR=1.59,95%CI:1.05~2.40,TT+TC vs CC:OR=2.19,95%CI:1.03~4.66),(CC+TC vs TT:OR=0.36,95%CI:0.19~0.68),the differences were statistically significant(Z=2.68,2.72,2.21,2.03,3.12,all P<0.05).Turkish TT genotype was associated with DPN risk(TT vs CC:OR=3.58,95%CI:1.59~8.03,CC+TC vs TT:OR=0.31,95%CI:0.14~0.69),the differences were statistically significant(Z=3.09,2.87,P=0.002,0.004).The Iranian CC+TC genotype was associated with increased risk of DPN(CC+TC vs TT:OR=2.84,95%CI:1.03~7.84),and the difference was statistically significant(Z=2.02,P=0.04).There was no correlation between MTHFR C677T gene polymorphism and DPN publication risk in Germany and Italy,and the difference was not statistically significant(Z=0.05~1.05,all P>0.05).Conclusion MTHFR C677T gene polymorphism and the risk of DPN would be related to countries and regions.Detection of this gene is helpful to predict the risk of DPN in China,Turkey and Iran,so as to provide reference for clinical diagnosis and treatment.

关 键 词：亚甲基四氢叶酸还原酶 糖尿病周围神经病 基因多态性 META分析 

分 类 号：R587.2[医药卫生—内分泌] Q786[医药卫生—内科学]