BACKGROUND The peripheral level of matrix metalloproteinase (MMP)-9 and polymorphism of MMP9 -1562C>T in patients with obstructive sleep apnea (OSA) remains controversial. Therefore, the aims of this systemic review and meta-analysis are to assess the MMP9 level in OSA patients and identify the relationship between MMP9 -1562C>T and OSA susceptibility. METHODS This systematic review was performed following the PRISMA guideline. We searched for studies in major databases, identifying those indexed from inception to July 3, 2019 which related to MMP9 level, MMP9 -1562C>T and OSA. The pooled standardized mean differences (SMDs) and 95% confidence interval (CI) of MMP9 levels were calculated. In addition, the relationship between MMP9 -1562C>T and OSA susceptibility was assessed by three genetic models. The heterogeneity analysis and calculation of the pooled odds ratio (OR) were also performed, followed by quality assessment using the Newcastle-Ottawa Scale (NOS). RESULTS In sum, our review included 15 eligible studies regarding MMP9 level and three regarding MMP9 -1562C>T. The pooled results showed that peripheral level of MMP9 was increased in OSA patients (SMD = 1.37; 95% CI = 1.15-1.59). Furthermore, significant difference of MMP9 level can be found between severe and mild-to-moderate OSA patients (SMD = 28.17; 95% CI = 4.23-52.11) or between moderate-severe and mild OSA (SMD = 36.62; 95% CI = 12.19-61.04). However, no relationship was observed between MMP9 -1562C>T and OSA susceptibility in three genetic models (Homozygote model, OR = 1.37; 95% CI = 0.87-2.18); (Recessive model, OR = 1.42; 95% CI = 0.83-2.42); (Allele model, OR = 1.07; 95% CI = 0.96-1.18). CONCLUSIONS This systemic review and meta-analysis indicated that the level of MMP9 was increased in patients with OSA and this increase is relevant to OSA severity. Moreover, the relationship between MMP9 -1562 C>T and OSA susceptibility has currently not been proven by current merging values. Further analyses with larger sample size are required to verify these associations.

中文翻译：

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阻塞性睡眠呼吸暂停患者的基质金属蛋白酶 9 (MMP9) 水平和 MMP9 -1562C>T：病例对照研究的系统回顾和荟萃分析。


背景 阻塞性睡眠呼吸暂停（OSA）患者的外周基质金属蛋白酶（MMP）-9水平和MMP9 -1562C>T多态性仍存在争议。因此，本系统评价和荟萃分析的目的是评估 OSA 患者的 MMP9 水平并确定 MMP9 -1562C>T 与 OSA 易感性之间的关系。方法 本系统评价是按照 PRISMA 指南进行的。我们在主要数据库中检索了研究，确定了从开始到 2019 年 7 月 3 日索引的与 MMP9 水平、MMP9 -1562C>T 和 OSA 相关的研究。计算了 MMP9 水平的汇总标准化平均差 (SMD) 和 95% 置信区间 (CI)。此外，通过三种遗传模型评估了MMP9 -1562C>T与OSA易感性之间的关系。还进行了异质性分析和合并优势比（OR）计算，然后使用纽卡斯尔-渥太华量表（NOS）进行质量评估。结果 总之，我们的综述包括 15 项有关 MMP9 水平的合格研究和 3 项有关 MMP9 -1562C>T 的研究。汇总结果显示 OSA 患者外周 MMP9 水平升高（SMD = 1.37；95% CI = 1.15-1.59）。此外，重度和轻至中度 OSA 患者（SMD = 28.17；95% CI = 4.23-52.11）或中重度和轻度 OSA 患者（SMD = 36.62；95% CI = 12.19-61.04）。然而，在三种遗传模型中没有观察到MMP9 -1562C>T与OSA易感性之间的关系（纯合子模型，OR = 1.37；95% CI = 0.87-2.18）； （隐性模型，OR = 1.42；95% CI = 0.83-2.42）； （等位基因模型，OR = 1.07；95% CI = 0.96-1.18）。 结论 这项系统评价和荟萃分析表明，OSA 患者中 MMP9 水平升高，并且这种升高与 OSA 严重程度相关。此外，MMP9 -1562 C>T 与 OSA 易感性之间的关系目前尚未得到当前合并值的证明。需要更大样本量的进一步分析来验证这些关联。