TLR4 Asp299Gly (rs4986790) polymorphism and coronary artery disease: a meta-analysis.
TLR4 Asp299Gly (rs4986790) polymorphism and coronary artery disease: a meta-analysis.
复制标题
TLR4 Asp299Gly (rs4986790) 多态性与冠状动脉疾病：荟萃分析
作者：
Chen R;Gu N;Gao Y;Cen W
背景。先前的研究在Toll样受体4（TLR4）Asp299Gly（rs4986790）多态性与冠状动脉疾病（CAD）之间的关联上显示出相互矛盾的结果。本研究的目的是评估TLR4 Asp299Gly多态性对CAD风险、C反应蛋白（CRP）水平以及冠状动脉狭窄数量的影响，并探讨G等位基因携带者是否能从他汀类药物治疗中获益更多。
方法。检索PubMed、EMBASE和中国知网数据库直至2015年5月。所有统计检验均使用R 3.1.2版本进行。采用比值比（OR）和95%置信区间（CI）来评估TLR4 Asp299Gly多态性与CAD风险、狭窄血管数量以及根据他汀类药物治疗患者的心血管事件发生率之间的关联。计算Asp299Gly与CRP水平之间关联的加权均数差（WMD）。
结果。总体而言，纳入了12项病例对照研究，包括10258例病例和5891例对照，未发现TLR4 Asp299Gly多态性与CAD存在关联（G等位基因与A等位基因：OR = 0.97，95%CI[0.81 - 1.17]，P = 0.75；AA与GG + AG：OR = 0.97，95%CI[0.80 - 1.18]，P = 0.76；GG与AG + AA：OR = 1.08，95%CI[0.57 - 2.02]，P = 0.82；AG与AA + GG：OR = 1.03，95%CI[0.85 - 1.25]，P = 0.74）。此外，未发现Asp299Gly与CRP水平之间存在关联（WMD = -0.10，95%CI[-0.62, 0.41]，P = 0.69）。再者，未报道他汀类药物与299Gly之间存在协同效应（他汀类药物_AA与他汀类药物_AG/GG：OR = 1.12，95%CI[0.41 - 3.09]，P = 0.82）。
讨论。这项荟萃分析表明TLR4 Asp299Gly多态性与CAD和CRP水平无关联。进一步表明G等位基因携带者可能不会从他汀类药物治疗中获益更多。进一步的研究应包括大样本量和高质量的文献，以深入了解这一问题。
Background. Previous studies have shown conflicting results on the association between toll-like receptor 4 (TLR4) Asp299Gly (rs4986790) polymorphism and coronary artery disease (CAD). The aim of this study was to evaluate the influence of TLR4 Asp299Gly polymorphism on CAD risk, CRP level and the number of stenotic coronary arteries, as well as to investigate whether G allele carriers would benefit more from statin treatment. Methods. PubMed, EMBASE, and CNKI databases were searched until May 2015. All the statistical tests were performed using R version 3.1.2. Odds ratio (OR) and 95% confidence interval (CI) were used to assess the association between TLR4 Asp299Gly polymorphism and CAD risk, the number of stenotic vessels, and the incidence of cardiovascular events according to statin-treated patients. Weighted mean difference (WMD) was calculated for the association between Asp299Gly and CRP level. Results. Overall, 12 case-control studies with 10,258 cases and 5,891 controls were included, and no association of TLR4Asp299Gly polymorphism with CAD was found (G allele vs. A allele: OR = 0.97, 95% CI [0.81–1.17], P = 0.75; AA vs. GG + AG: OR = 0.97, 95% CI [0.80–1.18], P = 0.76; GG vs. AG + AA: OR = 1.08, 95% CI [0.57–2.02], P = 0.82; AG vs. AA + GG: OR = 1.03, 95% CI [0.85–1.25], P = 0.74). Also, no association was noted between Asp299Gly and CRP level (WMD = −0.10, 95% CI [−0.62, 0.41], P = 0.69). Furthermore, no synergistic effect of statin and 299Gly was reported (Statin_AA vs. Statin_AG/GG: OR = 1.12, 95% CI [0.41–3.09], P = 0.82). Discussion. This meta-analysis suggests no association of TLR4 Asp299Gly polymorphism with CAD and CRP level. It is further indicated that the G allele carriers may not benefit more from statin treatment. Further studies should include large sample size and high-quality literature to understand this issue in depth.