Association of glucose-6-phosphate dehydrogenase deficiency and malaria: a systematic review and meta-analysis.
Association of glucose-6-phosphate dehydrogenase deficiency and malaria: a systematic review and meta-analysis.
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DOI：
10.1038/srep45963
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发表时间：
2017-04-06
影响因子：
4.6
通讯作者：
Hirayama K
中科院分区：
文献类型：
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作者：
Mbanefo EC;Ahmed AM;Titouna A;Elmaraezy A;Trang NT;Phuoc Long N;Hoang Anh N;Diem Nghi T;The Hung B;Van Hieu M;Ky Anh N;Huy NT;Hirayama K
葡萄糖-6-磷酸脱氢酶（G6 PD）缺乏症与疟疾地方病重叠，尽管它使携带者易于溶血。这一事实支持疟疾保护假说。本系统综述的目的是评估G6 PD缺乏症和疟疾之间的保护性关联的存在和程度。在13个数据库中检索了报告疟疾患者中任何G6 PD改变的论文。纳入的30项研究中有28项有资格进行荟萃分析。结果显示，G6 PD缺乏症与单纯性恶性疟疾之间无负相关（比值比（OR），0.77; 95%可信区间（CI），0.59-1.02; p = 0.07）。然而，这种负面的关联发生在非洲（OR，0.59; 95% CI，0.40-0.86; p = 0.007），但亚洲未发生（OR，1.24; 95%CI，0.96-1.61; p = 0.10），在杂合子中（OR，0.70; 95% CI，0.57-0.87; p = 0.001），但不是同型/半合子（OR，0.70; 95% CI，0.46-1.07; p = 0.10）。G6 PD缺乏症与总重度疟疾之间没有关联（OR，0.82; 95%CI，0.61-1.11; p = 0.20）。同样，与其他疟疾物种也没有联系。G6 PD缺乏症可以预防非洲国家的单纯性疟疾，但不能预防严重疟疾。有趣的是，这种保护主要是在杂合子中，是X连锁的，因此与性别有关。
Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency overlaps with malaria endemicity although it predisposes carriers to hemolysis. This fact supports the protection hypothesis against malaria. The aim of this systematic review is to assess the presence and the extent of protective association between G6PD deficiency and malaria. Thirteen databases were searched for papers reporting any G6PD alteration in malaria patients. Twenty-eight of the included 30 studies were eligible for the meta-analysis. Results showed absence of negative association between G6PD deficiency and uncomplicated falciparum malaria (odds ratio (OR), 0.77; 95% confidence interval (CI), 0.59–1.02; p = 0.07). However, this negative association happened in Africa (OR, 0.59; 95% CI, 0.40–0.86; p = 0.007) but not in Asia (OR, 1.24; 95% CI, 0.96–1.61; p = 0.10), and in the heterozygotes (OR, 0.70; 95% CI, 0.57–0.87; p = 0.001) but not the homo/hemizygous (OR, 0.70; 95% CI, 0.46–1.07; p = 0.10). There was no association between G6PD deficiency and total severe malaria (OR, 0.82; 95% CI, 0.61–1.11; p = 0.20). Similarly, there was no association with other malaria species. G6PD deficiency can potentially protect against uncomplicated malaria in African countries, but not severe malaria. Interestingly, this protection was mainly in heterozygous, being x-linked thus related to gender.