摘要目的 系统评价亚洲及欧洲人群血管内皮生长因子(VEGF)-460C/T及VEGF-634C/G基因多态性与糖尿病视网膜病变(DR)相关性.方法 通过美国国立医学图书馆PubMed、Cochrane Library、荷兰医学文摘EMBASE、重庆维普中文科技期刊全文数据库、万方科技期刊全文数据库、清华CNKI数据库检索文献,选取VEGF-460C/T及-634C/G基因多态性与DR关系的病例-对照研究进行meta分析.共纳入病例-对照研究20篇,共24组.符合Hardy-Weinberg遗传平衡(HWE)研究15篇,共17组,其中2篇文献同时研究了VEGF-460C/T及VEGF-634C/G,包括7组VEGF-460C/T[DR组899例,糖尿病无视网膜病变对照(DWR)组786例];10组VEGF-634C/G(DR组1690例,DWR组1804例).非HWE的研究5篇,其中2篇同时提供了2组数据(VEGF-460C/T组3组,VEGF-634C/G组4组).所有研究包括亚洲人14篇共17组,欧洲人6篇共7组.采用漏斗图对发表偏倚进行检测.结果 Meta分析结果显示,VEGF-460 C等位基因是亚洲糖尿病患者发生视网膜病变的危险基因[比值比(OR)=1.52,95％可信区间(CI)为1.22～1.90,Z=3.72;P=0.0002);CC基因型是亚洲糖尿病患者发生视网膜病变的危险基因型(OR=1.61,95％CI为1.19～2.19,Z=3.05;P=0.002).VEGF-634CC基因型是欧洲糖尿病患者发生视网膜病变的危险基因型(OR=1.56,95％CI为1.08～2.25,Z=2.37;P=0.02).未发现显著的发表偏倚.结论 VEGF-460C/T基因多态性与亚洲人DR发生相关,且C等位基因及CC基因型为其易感基因;VEGF-634C/G基因多态性与DR不相关,但其CC基因型可能与欧洲人DR发生有关.

abstractsObjective To assess the association of vascular endothelial growth factor (VEGF) gene-460C/T and-634C/G polymorphism with diabetic retinopathy (DR) among patients in Asia and European by meta-analysis.Methods A systematic search of electronic databases (PubMed,Cochrane Library,EMBASE,VIP,Wanfang technological,CNKI,etc.) was carried out until Jun,2014.Case-control studies on the relationship between genetic polymorphism of VEGF-460C/T and VEGF-634C/G with diabetic retinopathy were included in this analysis.The data were quantitatively analyzed by RevMan 5.0 software after assessing the quality of included studies.The pooled odds ratios (OR) and their corresponding 95％ confidence intervals (CI) were used to assess the strength of the association.Results VEGF-460C/T (7 studies:899 cases and 786 controls) and VEGF-634C/G (10 studies:1615 cases and 1861 controls) were inclued in this meta-analysis.Significant association was found for-460C/T polymorphism in Aisa (C versus T:OR=1.52,95％CI was [1.22,1.90],Z=3.72,P=0.0002;CC versus CT+TT:OR=1.61,95％CI was [1.19,2.19],Z=3.05,P=0.002;TT versus CT+CC:OR=0.64,95％CI was [0.41,0.98],Z=2.07,P=0.04),and VEGF-634CC gene type was associated with DR in European (OR=1.56,95％CI [1.08,2.25],Z=2.37,P=0.02).No significant publication bias was found.Conclusions The metaanalysis demonstrated that DR was associated with VEGF-460C/T polymorphism in Asia,and C alleles and CC gene type was the risk polymorphism;VEGF-634C/G polymorphism was not associated with DR,but its CC genotype maybe the risk factor in European.Further case-control studies based on larger sample size are still needed,especially for-634C/G polymorphism.