Are vitamin D receptor polymorphisms associated with bone mineral density? A meta‐analysis
Are vitamin D receptor polymorphisms associated with bone mineral density? A meta‐analysis
复制标题
维生素 D 受体多态性与骨矿物质密度相关吗？
DOI：
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发表时间：
1996
影响因子：
6.2
通讯作者：
D. Umbach
中科院分区：
文献类型：
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作者：
G. Cooper;D. Umbach
在一些研究中，维生素D受体(VDR)基因多态性与骨密度(BMD)有很强的相关性，但在另一些研究中则没有。我们使用荟萃分析方法来定量评估VDR和BMD之间的关联，并检查特定研究特征(例如，骨骼部位、受试者的平均年龄、绝经状态)对报告结果的影响。截至1996年7月，在同行评议期刊上发表的16篇论文被收录在内。我们计算平均差异、百分比差异和效应大小(平均差异除以标准差)，比较纯合子基因型之间的骨密度。在髋部，BB型的骨密度低于BB型(平均差值，−为0.02g/cm~2；百分比差值，−为2.4%；效应大小−为0.18；p=0.032)。在脊柱，平均差异为−0.03g/cm~2；百分比差异，−2.5%；效果大小，−0.19；p=0.062。在桡骨远端，VDR效应估计为平均差，−0.01g/cm~2；百分比差，−1.7%；效应大小，−0.16；p=0.078。脊柱测量在研究之间和研究内表现出最大的变异性。在年轻女性中，不同基因型之间的髋部骨密度差异更大(即，更负的数字)，并且似乎随着年龄的增长而减小。然而，这一趋势的统计证据很弱(p=0.06)。来自脊柱和桡骨的数据显示，没有证据表明VDR效应与年龄存在类似的交互作用。当我们从第一份报告中省略了VDR基因多态与BMD之间的关联数据时，我们的分析给出了类似的结果，尽管总体影响估计较小。在29个研究组的综合数据中，在白人、黑人和亚洲人的研究中，BB基因频率分别为17.2、4.9和2.3%。VDR基因多态性是影响BMD的一个遗传因素，但其机制、临床意义及其与其他遗传因素和环境因素的关系尚需进一步研究。
Vitamin D receptor (VDR) polymorphisms have been strongly associated with bone mineral density (BMD) in some studies but not in others. We used a meta‐analytic approach to assess quantitatively the association between VDR and BMD and to examine the influence of specific study characteristics (e.g., skeletal site, mean age of subjects, menopausal status) on the reported results. Sixteen papers published in peer‐reviewed journals through July 1996 were included. We calculated the mean difference, percent difference, and effect size (mean difference divided by standard deviation), comparing BMD between homozygous genotypes. At the hip, BMD in the BB genotype was lower than in the bb genotype (mean difference, −0.02 g/cm2; percent difference, −2.4%; and effect size −0.18; p = 0.032). At the spine, the mean difference was −0.03 g/cm2; percent difference, −2.5%; and effect size, −0.19; p = 0.062. At the distal radius, the VDR effect was estimated as the mean difference, −0.01 g/cm2; percent difference, −1.7% and effect size, −0.16; p = 0.078. The spine measurements exhibited the greatest between‐ and within‐study variability. The difference in hip BMD between genotypes was larger (i.e., a more negative number) among the younger women and seemed to decrease with increasing age. However, statistical evidence for this trend was weak (p = 0.06). Data from the spine and the radius showed no evidence of a comparable interaction of the VDR effect with age. When we omitted data from the first report of an association between VDR polymorphisms and BMD, our analyses gave similar results, although the overall effect estimates were smaller. In the combined data from 29 study groups, the BB genotype frequency was 17.2, 4.9, and 2.3% in studies of whites, blacks, and Asians, respectively. VDR polymorphisms represent one genetic factor affecting BMD, but further research into the mechanisms, clinical significance, and its relation between other genetic and environmental factors is needed.