对数线性模型在病例-父母/对照-母亲混合设计中的应用

以唇腭裂与亚甲基四氢叶酸还原酶(MTHFR)基因A1298C多样性的关系为例,基于似然比检验(LRT)的对数线性模型分析母亲、子代基因型与唇腭裂的关系,介绍应用对数线性模型分析病例-父母/对照-母亲混合设计资料的方法应用。发现母亲基因型为CC时,相对于基因型为AA的母亲,其子代唇腭裂发病风险降低,S₂=0.45(95%CI:0.26~0.79);子代基因型为AC时,相对于AA其发病风险降低,R₁=0.69(95%CI:0.48~0.97),其余未见关联。混合设计的效力要大于病例-父母对照研究(0.86>0.78)。表明MTHFR A1298C可能在唇腭裂的病因学机制中起重要作用。应用对数线性模型对这类混合设计资料的分析可以同时探讨母亲、子代基因型对疾病的影响,且相对病例-父母对照研究效力更高,适用于出生缺陷等生命早期疾病的病因学研究。     

不完全病例对照研究基因环境交互作用的估计

目的 介绍不完全病例对照研究中基因与环境交互作用的估计方法.方法 分别导出了logistic模型、对数线性模型在传统病例对照研究、单纯病例研究、不完全病例对照研究中主效应以及基因与环境交互作用效应的极大似然估计,并通过实例分析其应用价值.结果 在传统病例对照研究中,当数据未缺失时,logistic模型与对数线性模型的结果是等价的.当无对照时,单纯病例研究的logistic模型可以估计基因与环境的交互作用.当对照组基因信息缺失但环境信息齐全时,用传统病例对照研究的logistic模型无法得到交互作用的估计;用单纯病例研究的logistic模型可以估计交互作用,但由于没有充分利用环境的信息,故得不到环境主效应的估计;不完全病例对照研究的对数线性模型,可同时得到交互作用和环境主效应的估计.结论 不完全病例对照研究采用对数线性模型既可充分利用对照的环境暴露信息,估计环境的主效应,又可估计基因与环境的交互作用.当基因与环境暴露独立时,其估计值与完全数据是等价的.     

CYP450基因多态性及环境危险因素暴露与先天性心脏病关系病例对照研究

目的探讨子代CYP450基因多态性及母亲孕期环境危险因素暴露与先天性心脏病(CHD)发病的关系以及二者在CHD发生中是否存在交互作用。方法采用病例对照研究方法,将2011年10月-2013年1月在山东省济宁医学院第一附属医院确诊的160例0~7周岁单纯性CHD患儿和同期在该院进行体检或就诊的160例非心脏病幼儿分别作为病例组和对照组,采用访谈方式进行问卷调查,获得研究对象母亲孕期环境危险因素暴露信息,采集研究对象空腹静脉,血应用聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)检测CYP450基因多态性;应用单因素和多因素条件logistic回归模型分析子代CYP450基因多态性和母亲孕期环境危险因素暴露与CHD发病的关联强度,并采用相加模型交互作用指标评价二者的交互作用。结果多因素条件logistic回归分析结果显示,子代CYP1A1基因rs1048943位点纯合子突变型是CHD发病的保护因素(OR=0.369,95%CI=0.138~0.986);母亲孕前3个月使用染发剂(OR=5.621.95%CI=1.401~22.541)、孕前3个月被动吸烟(OR=2.511,95%CI=1.342~4.699)、孕早期被动吸烟(OR=2.441,95%CI=1.306~4.561)、孕早期居住在3年内装修过的居室(OR=4.159,95%CI=1.698~10.182)和孕早期服用解热镇痛药(OR=3.901,95%CI=1.271~11.971)是CHD发病的危险因素。交互作用分析结果显示,子代携带CYPIA1 rs1048943位点纯合子突变型有减弱环境因素致病风险的趋势,但交互作用指标无统计学意义。结论子代携带CYP1A1纯合子突变型对CHD发病有保护作用,母亲孕前及孕早期应尽量避免或减少环境危险因素的暴露,以预防子代CHD的发生。     

几种基因—环境、基因—基因交互作用研究方法的样本量比较

基因 -环境和基因 -基因交互作用在疾病发病中的作用日益引起人们的注意 ,相应的流行病学研究也逐渐增多。本文对三种基因 -环境和基因 -基因交互作用研究方法的样本量进行了比较 ,这三种方法分别是配比病例 -对照研究、病例 -同胞研究和病例 -父母研究。1　研究方法简介1 .1　配比 -病例对照研究 ( matched case- controlstudy)　病例和对照来源于同一人群 ,对照是未患所研究疾病的个体且与病例在匹配因素上保持一致 ,每个样本单位包含一个病例和 m个对照 ,m=1时称为配对 ( pair matching)。这种方法可以排除匹配因素的干扰。在研究遗传因…     

病例父母对照研究在遗传性疾病中的应用

现代分子生物技术和基因组信息学的发展,使进一步寻找疾病的易感基因成为可能,许多新的统计方法被引入多基因遗传病的研究,如群体关联分析(病例对照研究)、单纯病例研究、病例父母对照研究和患病亲属对研究,这些都是探索疾病的易感基因及研究基因与环境致病因素交互作用常用的研究方法.但是,病例对照研究在选择对照时要求很严格,该方法要求对照的遗传背景一致,而且由于群体的混合等容易造成虚假关联现象;单纯病例研究只能评估环境致病因素和易感基因都存在时的相乘模型交互作用,而不能单独评估易感基因的效应,以及它还存在不同亚人群暴露率和基因频率不一致所引起的偏倚.因此,Fack和Rubinstein提出了病例父母对照研究.     

母亲胱硫醚β-合酶基因多态性与子代先心病及亚型的关联研究北大核心CSCD

目的探讨母亲胱硫醚β-合成酶(cystathionineβsynthase,CBS)基因多态性与子代先心病(congenital heart disease,CHD)及其亚型的关联,为CHD遗传易感标志物的研究提供流行病学依据。方法以464例单纯CHD患儿母亲为病例组,504例正常儿童母亲为对照组,开展病例对照研究。通过问卷调查,收集研究对象的基本信息。完成调查问卷后,采集5ml血液,用于CBS基因多态性的检测。利用多因素logistic回归模型评估CBS基因多态性与CHD及亚型的关联;利用Haploview 4.2软件的四配子法构建单倍型,评估单倍型与CHD的关联;利用广义多因子降维法(GMDR)分析基因-基因交互作用与CHD的关联。结果多因素logistic回归分析结果显示,母亲CBS基因位点rs2851391和rs234714的多态性与子代CHD及其两种亚型(ASD和PDA)的发病存在关联;且经FDR调整后,关联仍然具有统计学意义(Q_(FDR)<0.05)。5个SNP位点均与VSD的发生无关(Q_(FDR)>0.05)。GMDR分析结果显示,5个SNP位点的基因-基因交互作用模型与子代CHD的发生无关(P>0.05)。rs1051319和rs2851391位点构成的单倍型G-T可能与子代CHD的发生有关(Q_(FDR)<0.05)。结论母亲CBS基因多态性与子代CHD、ASD和PDA的发生有关,CBS基因位点构成的单倍型(G-T)也与子代CHD的发生有关。     

孕期化学物接触及基因多态性与先天性心脏病

目的 探讨5,10-亚甲基四氢叶酸还原酶MTHFR基因C677T多态性和孕期接触化学物与先天性心脏病的关系.方法 采用病例-对照研究设计,选择144例病例和168例对照,采用面访法和聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)进行检测,运用多因素Logistic回归模型分析MTHFR基因C677T多态性与孕期化学物接触对先心病的作用强度和交互作用.结果 MTHFR677TT基因型发生先天性心脏病的风险是MTHFR677CT或CC基因型的3.215倍(95%CI=1.958～5.280);孕期化学物接触与子代先天性心脏病关联强度OR值为2.150(95%CI=1.041～4.442);MTHFR677TT基因型与孕期化学物接触具有正相加交互作用,交互作用的效应量(RERI)、归因交互效应百分比[AP(AB)]和纯因子间归因交互效应百分比[AP*(AB)]分别为4.938,60.23%,68.59%.结论 MTHFR基因C677T变异可与孕期接触化学物协同增加子代罹患先心病的危险性.     

母亲MTRR和MTR基因多态性与子代神经管畸形易感性Meta分析

目的分析母亲甲硫氨酸合成酶还原酶(MTRR)A66G和甲硫氨酸合成酶(MTR)A2756G基因多态性位点与子代神经管畸形的相关性,以期为评估个体化水溶性B族维生素代谢遗传风险,指导人群营养素缺乏风险监测,减少神经管畸形(neural tube defects,NTDs)发病率,提高出生人口健康水平,公共卫生政策的制定等提供相关的人类遗传学数据支持。方法搜集了1995-2017年已发表的中英文文献,通过荟萃分析探讨了MTRR A66G和MTR A2756G基因多态性位点与神经管畸形的相关性。结果荟萃分析结果显示,基于纯合子模型GG+AG vs AA,MTRR A66G基因多态性与子代神经管畸形存在相关性(OR=1.45,95%CI:1.15~1.84)。亚组分析显示,在亚洲人群纯合子模型GGvs AA中MTR A2756G基因多态性与子代神经管畸形存在相关性(OR=1.98,95%CI:1.02~3.83)。结论未来在不同地域不同人群中开展大样本量,基因-基因及基因-环境交互作用的多项研究,为预防神经管畸形提供分子生物学领域的科学依据显得尤为重要。     

应用多因子降维法分析基因-基因交互作用

目的介绍在遗传流行病学病例对照研究中,应用多因子降维法（MDR）分析基因-基因交互作用.方法简述MDR的基本步骤、原理及其特点,并结合研究实例说明在病例对照研究中如何应用软件进行MDR分析.结果相对于传统的统计学方法,MDR是一种无参数、无遗传模式的分析交互作用的方法,理论和实例研究均表明其分析交互作用具有较好的效能,目前已成功应用于散发性乳腺癌、心房颤动和原发性高血压等疾病的研究.结论 MDR能够应用于病例对照研究进行基因-基因交互作用的分析,且具有较传统的统计学分析方法无法比拟的优势.     

母亲胱硫醚β-合酶基因多态性与子代先心病及亚型的关联研究

目的 探讨母亲胱硫醚β-合成酶(cystathionineβsynthase, CBS)基因多态性与子代先心病(congenital heart disease, CHD)及其亚型的关联,为CHD遗传易感标志物的研究提供流行病学依据。方法 以464例单纯CHD患儿母亲为病例组,504例正常儿童母亲为对照组,开展病例对照研究。通过问卷调查,收集研究对象的基本信息。完成调查问卷后,采集5ml血液,用于CBS基因多态性的检测。利用多因素logistic回归模型评估CBS基因多态性与CHD及亚型的关联;利用Haploview 4.2软件的四配子法构建单倍型,评估单倍型与CHD的关联;利用广义多因子降维法(GMDR)分析基因-基因交互作用与CHD的关联。结果 多因素logistic回归分析结果显示,母亲CBS基因位点rs2851391和rs234714的多态性与子代CHD及其两种亚型(ASD和PDA)的发病存在关联;且经FDR调整后,关联仍然具有统计学意义(Q_FDR<0.05)。5个SNP位点均与VSD的发生无关(Q_FDR>0.05)。GM...     

Exploring the effects of methylenetetrahydrofolate reductase gene variants C677T and A1298C on the risk of orofacial clefts in 261 Norwegian case-parent triads

Folic acid and the methylenetetrahydrofolate reductase (MTHFR) gene have both been implicated in the etiology of orofacial clefts. The authors selected 261 case-parent triads (173 cases with cleft lip with or without cleft palate (CL/P) and 88 cases with cleft palate only (CPO)) from a Norwegian population-based study of orofacial clefts (May 1996-1998). A case-parent triad design was used to examine whether MTHFR variants C677T and A1298C, and their haplotypes, are risk factors for orofacial clefts. Among CL/P cases, the child's genotype at C677T or A1298C did not influence the risk. However, children of mothers carrying the C677T variant allele had a lower risk of CL/P. For CPO, children carrying the C677T variant allele had about a twofold increased risk, whereas the mother's genotypes did not contribute to the risk. The haplotype-based transmission/disequilibrium test showed that except for 677T/1298A (p = 0.06), none of the other haplotypes showed evidence of excess transmission to the offspring. The authors also explored interaction of C677T with maternal use of folic acid among children with CPO. Surprisingly, the risk associated with the child's carrying either CT or TT was higher (fourfold) when the mother used folic acid. These findings suggest a possible role of MTHFR and folic acid in the causation of orofacial clefts, but the strength and direction of these effects remain to be clarified.     

Maternal and fetal variants of genetic thrombophilias and the risk of preeclampsia

BACKGROUND: A woman's thrombophilic genes may increase her risk of preeclampsia in pregnancy. Vascular conditions of the placenta related to thrombophilic genes of the fetus could also be relevant for preeclampsia. The case-parent triad study design provides separate estimation of maternal and fetal genes. METHODS: We recruited 92 mother-father-child triads of preeclamptic pregnancies from a birth clinic in Stavanger, Norway. All parents were of Norwegian origin. Maternal, paternal, and fetal DNA were genotyped for the methylenetetrahydrofolate reductase (MTHFR) C677T and Factor V Leiden (FVL) G1691A SNPs. Estimation of the relative risk (RR) associated with fetal and maternal genetic variants was performed by log-linear models. RESULTS: There was no indication of an effect of the child's FVL alleles on preeclampsia risk. For case babies with 2 copies of the variant allele, the association with the MTHFR variant was inconclusive (RR = 1.6; 95% confidence interval [CI] = 0.6-4.3). Case mothers who were homozygous for the MTHFR variant had a relative risk of 2.0 (CI = 1.0-4.1) assuming a recessive gene effect. A 2.5-fold risk (CI = 1.1-5.7) of preeclampsia was estimated when the mother carried one copy of the FVL. Among mothers homozygous for the MTHFR variant, the relative risk of the FVL variant was 4.6-fold (CI = 1.0-21). CONCLUSIONS: We found little evidence of an effect of the child's MTHFR or FVL alleles on the risk of preeclampsia. Our estimates of effects of maternal MTHFR and FVL alleles were consistent with estimates from case-control studies. The case-parent triad design may be a useful tool for studies of pregnancy complications such as preeclampsia.     

Does the interaction between maternal folate intake and the methylenetetrahydrofolate reductase polymorphisms affect the risk of cleft lip with or without cleft palate?

Periconceptional folic acid supplementation may reduce the risk of cleft lip with or without cleft palate (CL(P)). Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene reduce availability of 5-methyltetrahydrofolate, the predominant circulating form of folate. To determine the effect of MTHFR C677T and MTHFR A1298C genotypes and haplotypes on CL(P) risk and the interaction with maternal periconceptional dietary folate and folic acid supplement intake, the authors conducted a case-control triad study in the Netherlands (1998-2000) among 179 CL(P) and 204 control families. Infant and parental MTHFR C677T and MTHFR A1298C genotypes and haplotypes were not associated with CL(P) risk in the case-control and transmission disequilibrium test analyses. Mothers carrying the MTHFR 677TT genotype and who either did not use folic acid supplements periconceptionally or had a low dietary folate intake, or both, had an increased risk of delivering a CL(P) child (odds ratio (OR) = 5.9, 95% confidence interval (CI): 1.1, 30.9; OR = 2.8, 95% CI: 0.7, 10.5; OR = 10.0, 95% CI: 1.3, 79.1, respectively). No supplement use, low dietary folate intake, and maternal MTHFR 1298CC genotype increased the risk of CL(P) offspring almost sevenfold (OR = 6.5, 95% CI: 1.4, 30.2). Thus, the detrimental effect of low periconceptional folate intake on the risk of giving birth to a CL(P) child was more pronounced in mothers with the MTHFR 677TT or MTHFR 1298CC genotype.     

Assessing maternal genetic associations: a comparison of the log-linear approach to case-parent triad data and a case-control approach

BACKGROUND: In utero exposures, including maternal phenotypes, are potential risk factors for both early-onset and adult-onset diseases. Two alternative study designs use maternal genotypes at polymorphic loci as biomarkers of an offspring's in utero exposure: (1) a traditional case-control study with logistic regression analysis, in which cases, controls, and mothers of both types of subjects are genotyped; and (2) a case-parent triad study with log-linear analysis, in which cases and both parents are genotyped. METHODS: We used computer simulations to compare the operating characteristics of the log-linear approach to case-parent triad data and the case-control approach for assessing relative risks (RRs) associated with maternal genotypes. RESULTS: For high-risk allele frequencies (chromosomal prevalence; f) between 0.20 and 0.75, both methods allowed for valid, unbiased estimates of maternal RRs. The case-parent triad approach, however, had 43% greater power, on average, than the case-control approach with an equal number of genotypes, and 13% greater power with an equal number of cases. For example, under dominant inheritance, to detect 2-fold maternal RRs with 200 (or 150) cases when allele prevalence is between 0.15 and 0.40, the case-parent triad and equal-genotype case-control designs had, on average, 87% and 62% power, respectively. As f approached 0 or 1, the power of both methods decreased sharply. DISCUSSION: The greater efficiency of case-parent triads may be due to the inclusion of paternal genotype information, which allows for independent tests of disease association with maternal or offspring genotypes. These results highlight one potential advantage of case-parent triad data in assessing maternal genetics as risk factors for offspring disease. We discuss these findings and other considerations between the 2 methodological approaches.     

Detecting genotype combinations that increase risk for disease: maternal-fetal genotype incompatibility test

Biological mechanisms that involve gene-by-environment interactions have been hypothesized to explain susceptibility to complex familial disorders. Current research provides compelling evidence that one environmental factor, which acts prenatally to increase susceptibility, arises from a maternal-fetal genotype incompatibility. Because it is genetic in origin, a maternal-fetal incompatibility is one possible source of an adverse environment that can be detected in genetic analyses and precisely studied, even years after the adverse environment was present. Existing statistical models and tests for gene detection are not optimal or even appropriate for identifying maternal-fetal genotype incompatibility loci that may increase the risk for complex disorders. We describe a new test, the maternal-fetal genotype incompatibility (MFG) test, that can be used with case-parent triad data (affected individuals and their parents) to identify loci for which a maternal-fetal genotype incompatibility increases the risk for disease. The MFG test adapts a log-linear approach for case-parent triads in order to detect maternal-fetal genotype incompatibility at a candidate locus, and allows the incompatibility effects to be estimated separately from direct effects of either the maternal or the child's genotype. Through simulations of two biologically plausible maternal-fetal genotype incompatibility scenarios, we show that the type-I error rate of the MFG test is appropriate, that the estimated parameters are accurate, and that the test is powerful enough to detect a maternal-fetal genotype incompatibility of moderate effect size.     

Methylenetetrahydrofolate Reductase (MTHFR) Gene Polymorphism and Infant’s Anthropometry at Birth

Identification of causal factors that influence fetal growth and anthropometry at birth is of great importance as they provide information about increased risk of disease throughout life. The association between maternal genetic polymorphism MTHFR(677)C>T and anthropometry at birth has been widely studied because of its key role in the one-carbon cycle. MTHFR(677) CT and TT genotypes have been associated with a greater risk of low birth weight, especially in case of deficient intake of folic acid during pregnancy. This study aimed to analyze the association between the maternal MTHFR(677)C>T genetic polymorphism and anthropometry at birth in a population with adequate folate consumption. We included 694 mother–newborn pairs from a prospective population-based birth cohort in Spain, in the Genetics, Early life enviroNmental Exposures and Infant Development in Andalusia (GENEIDA) project. Women were genotyped for MTHFR(677)C>T SNP by Q-PCR using TaqMan© probes. Relevant maternal and newborn information was obtained from structured questionnaires and medical records. Results showed that maternal MTHFR(677)C>T genotype was associated with newborn anthropometry. Genotypes CT or CT/TT showed statistically significant associations with increased or decreased risk of large-for-gestational-age (LGA) or small-for-gestational-age (SGA) based on weight and height, depending on the newborn’s sex, as well as with SGA in premature neonates. The relationships between this maternal genotype and anthropometry at birth remained despite an adequate maternal folate intake.     

Thrombophilic polymorphisms and intrauterine growth restriction

BACKGROUND: The relationship between thrombophilic polymorphisms and intrauterine growth restriction remains unclear. Whereas a subset of these polymorphisms have received some attention, others have not. METHODS: We conducted a case-control study of 493 cases of intrauterine growth restriction (birthweight less than the 10th percentile for gestational age and sex) and 472 controls (greater than the 10th percentile). We also conducted a family study including approximately 250 case trios (affected newborn, mother, and father) for each studied gene. Plasminogen activator inhibitor-1(PAI-1) 4G/5G and Factor XIII Val134Leu variants were compared between maternal and newborn cases and controls. Relative risks for newborn and maternal PAI-1 and Factor XIII genotypes in case trios were estimated using a log-linear model. Transmission of MTHFR C677T and 1298C haplotypes was analyzed in case trios, and the estimated haplotype distribution compared between cases and controls. Finally, we explored pairwise gene-gene interactions between all measured polymorphisms, including Factor V Leiden G1691A and Prothrombin G20210A. RESULTS: PAI-1 and Factor XIII polymorphisms were not associated with an increased risk of intrauterine growth restriction in the case-control analysis, and the case-parent analysis showed no newborn or maternal excess genotype relative risk. No excess transmission of the MTHFR haplotypes was observed in case newborns, and the distribution of MTHFR haplotypes was similar between cases and controls. Some results were suggestive of interactions between genes. CONCLUSIONS: Overall, there seems to be little or no indication that thrombophilic genes, at least individually, have an effect on intrauterine growth restriction.     

An investigation of folate-related genetic factors in the determination of birthweight

Recent evidence suggests that maternal folate status in early gestation is a significant determinant of infant birthweight. Folate metabolism is known to be controlled by genetic factors, with a number of polymorphic variations in folate metabolising genes identified, several of which have well-documented functional effects. The current study investigated whether folate-related polymorphic variation, in association with low maternal folate status, influences birthweight. Red blood cell (RBC) folate analysis and genotyping of five polymorphisms in folate-related genes [Methylenetetrahydrofolate reductase (MTHFR) 677C>T; MTHFR 1298A>C; cystathionine-beta-synthase (CbetaS) 844ins68bp; serine hydroxymethyltransferase (SHMT) 1420C>T; reduced folate carrier-1 (RFC-1) 80G>A] were undertaken in mothers and infants from 998 pregnancies. These data were analysed in relation to infant birthweight, adjusted for gender and gestational age (z-score). Low maternal RBC folate status was associated with reduced infant birthweight. None of the genetic variants studied showed an independent association with infant birthweight. However, two genetic variants were shown to have a significant effect on birthweight when found in association with low maternal RBC folate status. When individuals with variant genotypes and mothers with folate in the lowest quintile were compared with wild-type individuals and mothers with folate in the highest quintile, the following differences in mean birthweight (z-score) were observed; maternal MTHFR 677C>T (-0.56 [95% CI -1.00, -0.12]P=0.01) and infant CbetaS 844ins68bp (-0.71 [95% CI -1.97, -0.07]P=0.03). The findings of this study suggest that folate-related genetic polymorphisms do not directly influence infant birthweight. However, when placed on a background of deficient maternal nutritional status, they may detrimentally affect fetal growth.     

中国人群WNT代谢通路与非综合征型唇腭裂的亲源效应分析

目的 非综合征型唇裂合并或不合并腭裂（NSCL/P）是一类常见的出生缺陷,遗传致病因素一直是其病因学研究的热点。本研究拟基于家系设计在WNT代谢通路基因中探索亲源效应对NSCL/P发病风险的影响。方法 本研究人群为“唇腭裂的基因组学国际合作组研究”项目在中国地区募集的806个NSCL/P核心家系。利用对数线性模型探索WNT基因及其单体型的亲源效应与疾病的关联,采用Wald检验探索亲源效应与环境因素的交互作用。经过Bonferroni多重检验校正后,统计学检验的显著性阈值设为P<3.47×10^-4。结果 质量控制后共纳入7个基因上144个单核苷酸多态性位点进行分析。结果显示,NSCL/P家系中有8个位点具有潜在的亲源效应（P<0.05）,但经Bonferroni多重检验校正后,均未达到统计学显著性水平（P>3.47×10^-4）。NSCL/P家系中位于WNT9A rs4074668-rs12725747单体型（T-A）具有亲源效应,且经Bonferroni校正后差异仍有统计学意义（P=2.74×10^-4）。但该单体型的亲源效应与环境因素（被动吸烟、复合维生素补充）的交互作用并未达到统计学显著水平。结论 WNT代谢通路基因可能通过亲源效应影响NSCL/P的发生风险。位于WNT9A基因rs4074668-rs12725747单体型（T-A）亲源效应与NSCL/P发病风险存在显著关联。未来仍需其他独立样本验证以进一步确认WNT代谢通路在NSCL/P发生中的作用。