Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (33): 5405-5412.doi: 10.3969/j.issn.2095-4344.2833
Feng Chengqin1, Zeng Ping2, Luo Jun1, Liu Jinfu1, Huang Jiaxing1
1Graduate School of Guangxi University of Chinese Medicine, Nanning 530299, Guangxi Zhuang Autonomous Region, China; 2Second Department of Orthopedics, First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, Guangxi Zhuang Autonomous Region, China
Received:
2019-11-20
Revised:
2019-11-29
Accepted:
2020-01-17
Online:
2020-11-28
Published:
2020-10-15
Contact:
Zeng Ping, MD, Chief physician, Doctoral supervisor, Second Department of Orthopedics, First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, Guangxi Zhuang Autonomous Region, China
About author:
Feng Chengqin, Master candidate, Physician, Graduate School of Guangxi University of Chinese Medicine, Nanning 530299, Guangxi Zhuang Autonomous Region, China
Supported by:
CLC Number:
Feng Chengqin, Zeng Ping, Luo Jun, Liu Jinfu, Huang Jiaxing. Associations between vitamin D receptor gene polymorphisms and osteoarthritis: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(33): 5405-5412.
2.1 文献检索结果 按检索策略检索数据库,通过阅读题目和摘要初步筛选可能符合的文献,在Web of Science数据库检索到19篇,PubMed数据库检索到22篇,Cochrane Library检索到5篇,EMbase检索到18篇,CNKI检索到1篇,中国生物医学文献数据库检索到1篇,通过Endnote软件去除重复文献38篇,阅读全文后剔除7篇诊断标准不符合纳入标准的文献,最后21篇文献符合Meta分析[12-13,15-33],包括20篇英文文献和1篇中文文献。流程图详见图1。21篇文献中共7 109例患者,其中包括病例组3 123例骨关节炎患者、对照组非骨关节炎患者4 006例。 "
在纳入的研究中,8篇文献对病例组1 211例和对照组 2 061例进行了ApaI多态性与骨关节炎的相关性研究,5篇文献对病例组896例和对照组789例进行了BsmI多态性与骨关节炎的相关性研究,6篇文献对病例组767例和对照组1 432例进行了FokI多态性与骨关节炎相关性研究,16篇文献对病例组2 506例和对照组2 749例进行了TaqI多态性与骨关节炎相关性研究。HUANG等[13]的研究结果虽然提供了手部、髋部和膝关节骨关节炎3组比较的数据,但多部位骨关节炎患者纳入了不止一组比较。在对照组中也有类似的情况,其中一些被包括在多次比较中,所以为了避免重复,病例组只纳入膝关节组,对照组为无骨关节炎组。各纳入研究的基本资料见表1。所有纳入的研究都是高质量的,NOS评分为≥6分,见图2。 "
在纳入的研究中,8篇文献对病例组1 211例和对照组 2 061例进行了ApaI多态性与骨关节炎的相关性研究,5篇文献对病例组896例和对照组789例进行了BsmI多态性与骨关节炎的相关性研究,6篇文献对病例组767例和对照组1 432例进行了FokI多态性与骨关节炎相关性研究,16篇文献对病例组2 506例和对照组2 749例进行了TaqI多态性与骨关节炎相关性研究。HUANG等[13]的研究结果虽然提供了手部、髋部和膝关节骨关节炎3组比较的数据,但多部位骨关节炎患者纳入了不止一组比较。在对照组中也有类似的情况,其中一些被包括在多次比较中,所以为了避免重复,病例组只纳入膝关节组,对照组为无骨关节炎组。各纳入研究的基本资料见表1。所有纳入的研究都是高质量的,NOS评分为≥6分,见图2。 "
结果显示当忽略MUKHTAR等[12]的研究结果时,I2值由>50%变为<50%,所以异质性的来源是MUKHTAR等[12]的研究。维生素D受体FokI(FF vs Ff+ff)的研究行敏感性分析未找出明显异质性来源。通过仔细阅读MUKHTAR等[12]的研究,发现病例组及对照组的纳入符合纳入标准,维生素D受体基因也是通过PCR技术测定,实验方法未发现明显异常,基因型数据分布符合哈代温伯格平衡定律。但此次研究是唯一一篇对巴基斯坦人的研究,文章中也提到在巴基斯坦,70%的婚姻是近亲结婚,这是遗传疾病遗传给下一代的主要原因,所以这可能是异质性存在的来源。发表偏倚检测对所有基因型进行Egger’s检验和Begg’s检验,未发现明显的发表偏倚,说明结果稳定性较高,各基因型多态性纳入研究的发表偏倚检测的P 值详见表3。 "
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