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目的采用Meta分析方法对TLR4基因Asp299Gly多态性与强直性脊柱炎(AS)的关系进行系统评价,探寻AS发病遗传背景的循证医学证据。方法以“强直性脊柱炎”和“toll样受体4或TLR4”和“多态性”为关键词,全面检索Pub Med医学网站、中国学术期刊全文数据库、中国生物医学文献、万方等全文数据库,筛选TLR4基因多态性与AS关系的文献,截止2015年7月,筛选有详细信息的相关全文文献,根据是否为病例对照研究等纳入标准,对筛选文献中提供准确数据的文献进行Meta分析,根据资料有同质性,采用固定效应模型,合并OR值,采用Egger’s检验漏斗图对称性评价发表偏倚,系统评价TLR4基因Asp299Gly多态性与强直性脊柱炎的关联性。结果最终纳入6篇TLR4基因Asp299Gly多态性与强直性脊柱炎病例对照研究文献进行Meta分析,共计病例组851例,对照组842例。对照组人群均符合Hardy-Weinberg平衡。合并TLR4基因Asp299Gly位点的基因型(AG+GG)/AA,异质性检验Q检验统计量为5.82,I~2=48.5%,P>0.05,采用固定效应模型进行统计分析,合并值OR=1.04(95%CI=0.70~1.54),差异无统计学意义(P>0.05),Egger’s检验漏斗图对称性,P>0.05,无发表偏倚。合并TLR4基因Asp299Gly位点的等位基因G/A,异质性检验Q检验统计量为6.80,I~2=55.9%,P>0.05,采用固定效应模型进行统计分析,合并值OR=1.02(95%CI=0.70~1.50),差异无统计学意义(P>0.05)。Egger’s检验漏斗图对称性,P>0.05,无发表偏倚。结论尚不能认为TLR4基因Asp299Gly与AS易感性有关联。
Objective To evaluate the relationship between Asp299Gly polymorphism of TLR4 gene and ankylosing spondylitis (AS) by Meta-analysis, and to explore evidence-based medical evidence of the genetic background of AS. Methods A total search of Pub Med medical website, full-text database of Chinese academic journals, Chinese biomedical sciences, and other related keywords with “ankylosing spondylitis” and “toll-like receptor 4 or TLR4” and “polymorphism” as keywords Literature, Wanfang and other full-text databases to screen TLR4 gene polymorphisms and AS literature, as of July 2015, screening of relevant articles with detailed information, according to whether the case-control study inclusion criteria, the screening literature provides Meta-analysis was performed on the literature with accurate data. Based on the homogeneity of the data, a fixed effect model was used to combine the OR values. Egger’s test funnel diagram symmetry was used to evaluate publication bias. The association between TLR4 gene Asp299Gly polymorphism and ankylosing spondylitis Sex. Results Sixty-six TLR4 gene polymorphisms of Asp299Gly were compared with that of ankylosing spondylitis case-control study. A total of 851 cases were included and 842 cases of control group. The control group of people are in line with the Hardy-Weinberg equilibrium. The combined genotype (AG + GG) / AA of Asp299Gly in TLR4 gene was 0.82, 48% in I ~ 2 = 48.5%, P> 0.05. Statistical analysis was performed using fixed effect model. = 1.04 (95% CI = 0.70-1.54). The difference was not statistically significant (P> 0.05). Egger’s test showed symmetry of funnel, P> 0.05, and no publication bias. Combined with allele G / A of Asp299Gly in TLR4 gene, the test of heterogeneity Q test was 6.80, I ~ 2 = 55.9%, P> 0.05. Statistical analysis was performed using the fixed effect model with OR = 1.02 95% CI = 0.70 ~ 1.50), the difference was not statistically significant (P> 0.05). Egger’s test funnel pattern symmetry, P> 0.05, unpublished bias. Conclusion Asp299Gly, a TLR4 gene, can not be considered as associated with AS susceptibility.