脂蛋白脂酶基因S447X多态性与糖尿病关系的Meta分析

目的 探讨脂蛋白脂酶（LPL）基因S447X多态性与糖尿病（DM）易感性之间的关联。方法 检索PubMed、OvidSP、CBM、中国知网和万方数据，收集关于LPL S447X多态性与DM的病例-对照研究，2名评价者按筛选标准分析文献，提取资料，质量评价，并完成Meta分析和试验序贯分析（TSA）。结果 9篇文献被纳入Meta分析，2型DM（T2DM）患者G等位基因（OR = 0.66，95% CI为0.48 ~ 0.90，P = 0.01）和CG基因型（OR = 0.63，95% CI为0.43 ~ 0.91，P = 0.02）频率比对照组降低。TSA结果显示显性模型的累积Z值跨越传统界值线、TSA界值线和RIS线。与CC基因型相比，CG+GG基因型DM患者TG、TC和LDL - C水平降低，而HDL - C水平升高。结论 LPL基因S447X多态性G等位基因和CG基因型是T2DM的保护因素，可改善脂代谢异常而降低T2DM的患病风险。

Meta-analysis on the correlation between S447X polymorphism of lipoprotein lipase gene and diabetes mellitus

Objective To investigate the relationship between S447X polymorphism of lipoprotein lipase(LPL) gene and diabetes mellitus(DM). Methods Databases including PubMed, OvidSP, CBM, CNKI and Wanfang were searched to collect all case-control studies on the association between LPL S447X polymorphism and DM. According to the selection criteria, 2 reviewers screened the literatures, extracted data, evaluated the quality, and performed Meta-analysis and trial sequential analysis (TSA). Results Nine studies were collected into Meta-analysis. The frequencies of G allele (OR=0.66, 95%CI 0.48-0.90, P=0.01) and CG genotype (OR=0.63, 95%CI 0.43-0.91, P=0.02) in type 2 DM (T2DM) patients were significantly lower than those in the control group. TSA showed that the cumulative Z values of dominant model had already crossed the traditional boundary line, TSA threshold value line and RIS line. Compared with CC genotype, TG TC and LDL-C levels were decreased and HDL-C levels were increased in CG+GG genotype DM patients. Conclusion The G allele and CG genotype of LPL gene S447X polymorphism are protective factors for T2DM. The CG+GG genotype can improve the abnormalities of lipid metabolism and reduce the risk of T2DM.