Association between monoamine oxidase A promoter polymorphism and the risk of sudden infant death syndrome: a meta-analysis

Yu Zhang,Qiaoxia Zhou,Daoyin Gong,Feijun Huang

doi:10.1007/s00414-020-02496-6

Yu Zhang, Qiaoxia Zhou + Show 2 more

Open Access

https://doi.org/10.1007/s00414-020-02496-6

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Abstract

IntroductionThe etiology of sudden infant death syndrome (SIDS) remains an unsolved problem. The aim of this meta-analysis is to investigate the potential association between monoamine oxidase A (MAOA) promoter variable number tandem repeat (VNTR) polymorphism and SIDS risk.MethodsA systematic review and meta-analysis were conducted on studies from accessible electronic databases. Each VNTR variant was examined in each gender independently by comparing with the pooled results of other alleles.ResultsA total of six independent case–control studies including 1022 SIDS cases and 1839 controls were enrolled in this meta-analysis. In both of the whole populations and Caucasian populations, male infants with the low-MAOA-expression alleles (2R+3R) were found to exhibit a statistically significant increased risk of SIDS, whereas those with a 4R allele exhibited a reduced risk of SIDS. Besides, an increased risk of SIDS was detected in male Caucasian infants with 2R or 3R alleles. However, none of the allele or genotype variants was associated with SIDS in female victims.ConclusionIn male Caucasian infants, the low expression of MAOA promoter VNTR alleles (2R and 3R) is associated with an increased risk of SIDS, and the existence of the 4R allele could be regarded as a protective factor.

Highlights

The etiology of sudden infant death syndrome (SIDS) remains an unsolved problem
The inclusion criteria were as follows: (1) the studies were originally published as case–control studies; (2) the studies were on the correlation between monoamine oxidase A (MAOA) gene promoter polymorphism and the risk of SIDS; (3) the infants enrolled in the studies were diagnosed with SIDS according to systematic autopsy and strict guidelines; and (4) the number of infants with specific gene variants was presented as a real number instead of a statistical analysis result
The results showed that the low-MAOA-expression alleles (2R+ 3R) are associated with the occurrence of SIDS (OR = 1.31, 95% confidence intervals (CIs) = 1.03–1.67, P = 0.03; Fig. 4)

Summary

Introduction

The etiology of sudden infant death syndrome (SIDS) remains an unsolved problem The aim of this meta-analysis is to investigate the potential association between monoamine oxidase A (MAOA) promoter variable number tandem repeat (VNTR) polymorphism and SIDS risk. Increasing evidence has shown that autonomic nervous system disturbances may play an important role in the occurrence of SIDS, especially those involved in respiratory regulation and arousal reaction These impaired functions are associated with an abnormal serotonin level in the brainstem, 5-HT1A receptors, and multiple functional gene polymorphisms of the serotonin transporter, leading to a failure in homeostatic defensive responses to life-threatening problems during sleep [9,10,11]. In addition to serotonergic neurons, noradrenaline is one of the neurotransmitters involved in the modulation of respiratory activity and occurrence of SIDS [12] with evidence such as differences in expression of the tyrosine hydroxylase [13] and the identification of a functional polymorphism in the tyrosine hydroxylase gene as a risk factor of SIDS [14]

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