ABSTRACT

Studies on relationship between methylenetetrahydrofolate reductase gene (MTHFR) gene A1298C polymorphism with the risk of ischemic as well as hemorrhagic stroke have shown discordant results. Present meta-analysis was aimed to clarify the relationship between MTHFR gene A1298C polymorphism with risk of stroke. A comprehensive literature search for all published articles was performed in electronic database including PubMed, EMbase, Cochrane Library, Trip Databases, Worldwide Science, CINAHL, and Google Scholar up to 31st December 2019. Pooled odds ratio (ORs) with 95% confidence interval (CIs) under dominant, recessive, and allelic models was calculated. Sensitivity analysis was also performed to detect the heterogeneity. In our meta-analysis, a total of 20 studies with 19 case control studies involving 2871 ischemic stroke (IS) cases and 3984 controls and 3 studies with 201 hemorrhagic stroke cases and 1349 controls were included. Our findings suggest that there was a significant relationship between MTHFR gene A1298C gene polymorphism with risk of ischemic stroke (dominant model: OR = 1.32, 95% CI = 1.06–1.66, recessive model: OR = 1.45, 95% CI = 1.06–1.99 and allelic model: OR = 1.35, 95% CI = 1.00–1.84, respectively). However, no significant relationship between MTHFR gene A1298C gene polymorphism with the risk of hemorrhagic stroke. Findings of this meta-analysis concludes that MTHFR gene A1298 C polymorphism could be capable of increasing stroke susceptibility in Asian, but not in Caucasian population. Genotyping of MTHFR gene A1298C polymorphism may be used as a predictor for the occurrence of ischemic stroke.

摘要

亚甲基四氢叶酸还原酶基因 (MTHFR) 基因 A1298C 多态性与缺血性和出血性中风风险之间关系的研究显示出不一致的结果。本荟萃分析旨在阐明 MTHFR 基因 A1298C 多态性与卒中风险之间的关系。截至 2019 年 12 月 31 日，在包括 PubMed、EMbase、Cochrane Library、Trip Databases、Worldwide Science、CINAHL 和 Google Scholar 在内的电子数据库中对所有已发表文章进行了全面的文献检索。汇总优势比 (OR) 具有 95% 的置信区间（计算显性、隐性和等位基因模型下的 CIs)。还进行了敏感性分析以检测异质性。在我们的荟萃分析中，共纳入 20 项研究和 19 项病例对照研究，涉及 2871 例缺血性卒中 (IS) 病例和 3984 例对照，3 项研究包括 201 例出血性卒中病例和 1349 例对照。我们的研究结果表明，MTHFR 基因 A1298C 基因多态性与缺血性卒中风险之间存在显着相关性（显性模型：OR = 1.32，95% CI = 1.06-1.66，隐性模型：OR = 1.45，95% CI = 1.06-1.99和等位基因模型：OR = 1.35，95% CI = 1.00–1.84，分别）。但MTHFR基因A1298C基因多态性与出血性脑卒中风险无显着相关性。该荟萃分析的结果得出结论，MTHFR 基因 A1298 C 多态性可能能够增加亚洲人的中风易感性，但不能增加白种人人群的中风易感性。