[1]薛飞肖,李琼阁,宁 可,等.MTHFR 基因多态性与糖尿病周围神经病发生风险的meta 分析[J].现代检验医学杂志,2023,38(05):142-147.[doi:10.3969/j.issn.1671-7414.2023.05.027]
 XUE Feixiao,LI Qiongge,NING Ke,et al.Risk of MTHFR Gene Polymorphism and Diabetic Peripheral Neuropathy: A Meta-Analysis[J].Journal of Modern Laboratory Medicine,2023,38(05):142-147.[doi:10.3969/j.issn.1671-7414.2023.05.027]
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MTHFR 基因多态性与糖尿病周围神经病发生风险的meta 分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年05期
页码:
142-147
栏目:
论著
出版日期:
2023-09-15

文章信息/Info

Title:
Risk of MTHFR Gene Polymorphism and Diabetic Peripheral Neuropathy: A Meta-Analysis
文章编号:
1671-7414(2023)05-142-06
作者:
薛飞肖1李琼阁2宁 可1王 威1王海峰1
(1. 西安市第三医院检验科, 西安710018;2. 西安市人民医院/ 西安市第四医院药剂科,西安 710004)
Author(s):
XUE Feixiao1LI Qiongge2NING Ke1WANG Wei1WANG Haifeng1
(1. Department of Clinical Laboratory, the Third Hospital of Xi’an,Xi’an 710018,China;2. Department of Pharmacy, Xi’an People’s Hospital/the Fourth Hospital of Xi’an,Xi’an 710004,China)
关键词:
亚甲基四氢叶酸还原酶糖尿病周围神经病基因多态性Meta 分析
分类号:
R587.2;Q786
DOI:
10.3969/j.issn.1671-7414.2023.05.027
文献标志码:
A
摘要:
目的 分析亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因多态性与糖尿病周围神经病(diabetic peripheral neuropathy,DPN)发生风险的关系。方法 计算机检索PubMed,the Cochrane Library,Embase,中国知网和万方医学网数据库自建库~ 2021 年11 月发表的关于MTHFR C677T 基因多态性与DPN 相关的病例对照研究,采用纽卡斯尔- 渥太华评价表(Newcastle-Ottawa Scale ,NOS) 评价文献质量。以比值比(odds ratio,OR)为效应指标,统计学分析采用RevMan5.3 软件。结果 共纳入9 项病例对照研究,包括751 例病例组和854 例对照组。Meta 分析显示,T 等位基因(R=1.54,95%CI: 1.08 ~ 2.18)与DPN 发生风险相关,差异有统计学意义(Z=2.41,P=0.02)。亚组分析显示,中国MTHFR C677T 基因多态性与DPN 发生风险相关(T vs C:OR=2.04,95%CI:1.21 ~ 3.44;TT vs CC:OR=3.90,95%CI:1.46 ~ 10.37;TC vs CC:OR=1.59,95%CI:1.05 ~ 2.40;TT+TC vs CC:OR=2.19,95%CI:1.03 ~ 4.66;CC+TC vs TT:OR=0.36,95%CI:0.19 ~ 0.68),差异有统计学意义(Z=2.68,2.72,2.21,2.03,3.12,均P<0.05)。土耳其TT 基因型与DPN 风险相关(TT vs CC:OR=3.58,95%CI:1.59 ~ 8.03;CC+TC vs TT:OR=0.31,95%CI:0.14 ~ 0.69),差异有统计学意义(Z=3.09,2.87,P=0.002,0.004)。伊朗CC+TC 基因型与DPN风险增加有关(CC+TC vs TT:OR=2.84,95%CI:1.03 ~ 7.84),差异有统计学意义(Z=2.02,P=0.04)。德国、意大利MTHFR C677T 基因多态性与DPN 发病风险未见相关性,差异无统计学意义(Z=0.05 ~ 1.05,均P >0.05)。结论 MTHFR C677T 基因多态性与DPN 发生风险可能与国家地区有关,检测该基因有助于中国、土耳其和伊朗人群DPN 发病风险的预判,以期为临床诊疗提供参考。
Abstract:
Objective To analyze the risk of methylenetetrahydrofolate reductase(MTHFR) gene polymorphisms and diabetic peripheral neuropathy (DPN). Methods PubMed, the Cochrane Library, Embase, CNKI, Wanfang Medical databases were searched by computer to the case-control study on the correlation between MTHFR C677T gene polymorphism and DPN until November 2021. The quality of the literature was evaluated by Newcastle-Ottawa Scale (NOS). Statistical analysis was performed using RevMan5.33 and the odds ratio (OR) was used as the effect index. Results A total of 9 case-control studies were included, including 751 cases and 854. Meta-analysis showed that the T allele (OR=1.54,95%CI :1.08 ~ 2.18) was associated with the risk of DPN, and the difference was statistically significant (Z=2.41, P=0.02). Subgroup analysis showed that the polymorphism of MTHFR C677T gene was associated with the risk of DPN in China (T vs C: OR=2.04, 95%CI: 1.21 ~ 3.44, TT vs CC: OR=3.90, 95%CI: 1.46 ~ 10.37 ,TC vs CC: OR=1.59, 95%CI: 1.05 ~ 2.40 ,TT+TC vs CC: OR=2.19, 95%CI: 1.03 ~ 4.66) ,CC+TC vs TT: OR=0.36, 95%CI: 0.19 ~ 0.68), the differences were statistically significant (Z=2.68,2.72,2.21,2.03, 3.12, all P<0.05). Turkish TT genotype was associated with DPN risk (TT vs CC: OR=3.58, 95%CI: 1.59 ~ 8.03,CC+TC vs TT: OR=0.31, 95%CI: 0.14 ~ 0.69), the differences were statistically significant (Z=3.09,2.87,P=0.002, 0.004).The Iranian CC+TC genotype was associated with increased risk of DPN (CC+TC vs TT: OR=2.84, 95%CI: 1.03 ~ 7.84), and the difference was statistically significant (Z=2.02, P=0.04). There was no correlation between MTHFR C677T gene polymorphism and DPN publication risk in Germany and Italy, and the difference was not statistically significant(Z=0.05 ~ 1.05,all P>0.05). Conclusion MTHFR C677T gene polymorphism and the risk of DPN would be related to countries and regions. Detection of this gene is helpful to predict the risk of DPN in China, Turkey and Iran, so as to provide reference for clinical diagnosis and treatment.

参考文献/References:

[1] SELVARAJAH D, KAR D, KHUNTI K, et al. Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention[J].Lancet Diabetes Endocrinol, 2019, 7(12): 938-948.
[2] MIRANDA-MASSARI J R, GONZALEZ M J, JIMENEZ F J, et al. Metabolic correction in the management of diabetic peripheral neuropathy: improving clinical results beyond symptom control[J].Current Clinical Pharmacology, 2011, 6(4): 260-273.
[3] YIGIT S, KARAKUS N, INANIR A. Association of MTHFR gene C677T mutation with diabetic peripheral neuropathy and diabetic retinopathy [J].Mol Vis,2013,19:1626-1630..
[4] HUANG Tao, REN Jingjing, HUANG Jinyan, et al. Association of homocysteine with type 2 diabetes: a meta-analysis implementing Mendelian randomization approach[J].BMC Genomics,2013,14:867.
[5] 邱瑜.血清同型半胱氨酸水平及亚甲基四氢叶酸还原酶基因多态性与2 型糖尿病周围神经病变相关性研究[D]. 南昌:南昌大学, 2021. QIU Yu. Relationship between serum homocysteine level, methylenetetrahydrofolate reductase gene polymorphism and type 2 diabetic peripheral neuropathy[D]. Nanchang:Nanchang University, 2021.
[6] KAKAVAND HAMIDI A, RADFAR M, AMOLI M M. Association between MTHFR variant and diabetic neuropathy[J]. Pharmacological Reports, 2018, 70(1): 1-5.
[7] 罗晓琴, 江平, 程时磊. 青海地区育龄女性MTHFR基因C677 位点的多态性研究[J].现代检验医学杂志, 2021, 36(2): 89-91, 131. LUO Xiaoqin, JIANG Ping, CHENG Shilei. Study on the polymorphism distribution of MTHFR gene C677 in women of childbearing age in Qinghai[J]. Journal of Modern Laboratory Medicine, 2021, 36(2): 89-91, 131.
[8] 师文涛, 白蓉, 黄剑林, 等.陕西省延安地区汉族与国内其他地区育龄妇女MTHFR 基因C677T 位点基因型和等位基因分布研究[J].现代检验医学杂志,2020, 35(6): 78-84. SHI Wentao, BAI Rong, HUANG Jianlin, et al. Comparative study on MTHFR gene C677T locus genotype and allele distribution between Han nationality and women of childbearing age in Yan’an area of Shaanxi province[J]. Journal of Modern Laboratory Medicine, 2020, 35(6): 78-84.
[9] 曾宪涛, 刘慧, 陈曦, 等.Meta 分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299. ZENG Xiantao, LIU Hui, CHEN Xi, et al. Metaanalysis series IV:Quality assessment tools for observational studies[J]. Chinese Journal of Evidence-Bases Cardiovascular Medicine, 2012, 4(4): 297-299.
[10] JIM?NEZ-RAM?REZ F J, CASTRO L M, ORTIZ C, et al. Role of treatment-modifying MTHFR677C>T and 1298A>C polymorphisms in metformin-treated Puerto Rican patients with type-2 diabetes mellitus and peripheral neuropathy[J]. Drug Metabolism and Personalized Therapy, 2017, 32(1): 23-32.
[11] RUSSO G T, GIANDALIA A, ROMEO E L, et al. Diabetic neuropathy is not associated with homocysteine, folate, vitamin B12 levels, and MTHFR C677T mutation in type 2 diabetic outpatients taking metformin [J]. Journal of Endocrinological Investigation, 2016, 39(3): 305-314.
[12] WANG Hongli, FAN Dongsheng, HONG Tianpei, et al. Is the C677T polymorphism in methylenetetrahydrofolate reductase gene or plasma homocysteine a risk factor for diabetic peripheral neuropathy in Chinese individuals?[J]. Neural Regeneration Research, 2012, 7(30): 2384-2391.
[13] UKINC K, ERSOZ H O, KARAHAN C, et al. Methyltetrahydrofolate reductase C677T gene mutation and hyperhomocysteinemia as a novel risk factor for diabetic nephropathy[J]. Endocrine, 2009, 36(2): 255-261.
[14] 孙磊, 陈丽, 任建民, 等. 同型半胱氨酸及其相关酶基因多态性与糖尿病周围神经病变的关系[J]. 中华内分泌代谢杂志, 2004, 20(6): 54-55. SUN Lei, CHEN Li, REN Jian-min, et al. Relationship of plasma homocysteine and gene polymorphism of homocysteine metabolism related enzyme with diabetic peripheral neuropathy [J]. Chinese Journal of Endocrinology and Metabolism, 2004, 20(6): 54-55.
[15] AMBROSCH A, DIERKES J, LOBMANN R, et al. Relation between homocysteinaemia and diabetic neuropathy in patients with type 2 diabetes mellitus [J].Diabetic Medicine, 2001, 18(3): 185-192.
[16] SETTIN A, EL-BAZ R, ISMAEEL A, et al. Association of ACE and MTHFR genetic polymorphisms with type 2 diabetes mellitus:Susceptibility and complications[J].Journal of the Renin-Angiotensin-Aldosterone System, 2015, 16(4): 838-843.
[17] LIEW S C, GUPTA E D. Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: epidemiology, metabolism and the associated diseases[J]. European Journal of Medical Genetics, 2015, 58(1): 1-10.
[18] STEVENSON R E, SCHWARTZ C E, DU Y Z, et al. Differences in methylenetetrahydrofolate reductase genotype frequencies,between Whites and Blacks[J].American Journal of Human Genetics, 1997, 60(1): 229-230.
[19] 张燕, 王伟红, 郝万鹏. 乌鲁木齐汉族妇女亚甲基四氢叶酸还原酶基因变异与血清叶酸和同型半胱氨酸水平的相关性研究[J]. 现代检验医学杂志, 2019,34(5): 98-100, 105. ZHANG Yan, WANG Weihong, HAO Wanpeng. Study on the correlation between the variation of methylenetetrahydrofolate reductase gene and folate and homocysteine Urumqi Han women[J]. Journal of Modern Laboratory Medicine, 2019, 34(5): 98-100, 105.
[20] FROSST P, BLOM HJ, MILOS R, et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase [J].Nature Genetics, 1995, 10(1): 111-113.
[21] 王美英, 韩艳秋.呼和浩特地区表观健康成年人群血清同型半胱氨酸水平分析和参考区间建立[J]. 现代检验医学杂志, 2022, 37(6): 144-148. WANG Meiying, HAN Yanqiu. Serum homocysteine level analysis and reference interval establishment of epigenetically healthy adult population in Hohhot, Inner Mongolia[J]. Journal of Modern Laboratory Medicine, 2022, 37(6): 144-148.
[22] 刘倩倩, 刘兴晖, 王海明, 等.2 型糖尿病患者血糖控制与血清Hcy 水平及其他影响因素的相关性研究[J].现代检验医学杂志, 2019, 34(3): 77-81. LIU Qianqian, LIU Xinghui, WANG Haiming, et al. Effect of glycemic control on serum homocysteine levels in type 2 diabetes mllitus and its association with other factors[J]. Journal of Modern Laboratory Medicine, 2019, 34(3): 77-81.
[23] MOTTAGHI T, KHORVASH F, KHEIROLLAHI M, et al. The MTHFR C677T polymorphism influences the efficacy of folic acid supplementation on the nerve conduction studies in patients with diabetic polyneuropathy; A randomized, double blind, placebocontrolled study [J].Journal of Research in Medical Sciences, 2019, 24:36.

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备注/Memo

备注/Memo:
基金项目:陕西省科技厅重点研发计划项目(NO. 2018SF-090):ApoE4 基因引起内质网应激促tau 蛋白磷酸化机制研究。
作者简介:薛飞肖(1990-),女,硕士,主管检验技师。研究方向:临床检验诊疗技术,E-mail: aixx0225@sina.com。
通讯作者:王海峰(1971-),男,硕士,主任技师,研究方向:临床检验管理与诊断,E-mail: xasyjykwhf@sina.com。
更新日期/Last Update: 2023-09-15