Abstract
ObjectiveThis meta-analysis was conducted to evaluate the correlations of a common polymorphism (677C>T) in the methylenetetrahydrofolate reductase (MTHFR) gene with risk of cardiovascular disease (CVD) in patients with end-stage renal disease (ESRD).MethodThe following electronic databases were searched without language restrictions: Web of Science (1945∼2013), the Cochrane Library Database (Issue 12, 2013), MEDLINE (1966∼2013), EMBASE (1980∼2013), CINAHL (1982∼2013) and the Chinese Biomedical Database (CBM) (1982∼2013). Meta-analysis was performed using STATA statistical software. Odds ratios (ORs) with their 95% confidence intervals (95%CIs) were calculated.ResultsEight cohort studies met all inclusion criteria and were included in this meta-analysis. A total of 2,292 ESRD patients with CVD were involved in this meta-analysis. Our meta-analysis results revealed that the MTHFR 677C>T polymorphism might increase the risk of CVD in ESRD patients (TT vs. CC: OR = 2.75, 95%CI = 1.35∼5.59, P = 0.005; CT+TT vs. CC: OR = 1.39, 95%CI = 1.09∼1.78, P = 0.008; TT vs. CC+CT: OR = 2.52, 95%CI = 1.25∼5.09, P = 0.010; respectively). Further subgroup analysis by ethnicity suggested that the MTHFR 677C>T polymorphism was associated with an elevated risk for CVD in ESRD patients among Asians (TT vs. CC: OR = 3.38, 95%CI = 1.11∼10.28, P = 0.032; CT+TT vs. CC: OR = 1.44, 95%CI = 1.05∼1.97, P = 0.022; TT vs. CC+CT: OR = 3.15, 95%CI = 1.02∼9.72, P = 0.046; respectively), but not among Africans or Caucasians (all P>0.05).ConclusionOur findings indicate that the MTHFR 677C>T polymorphism may be associated with an elevated risk for CVD in ESRD patients, especially among Asians.
Highlights
Hemodialysis (HD) is a common form of dialysis therapy for kidney disease by achieving the extracorporeal removal of waste products such as creatinine, urea and free water from the blood [1]
Our meta-analysis results revealed that the methylenetetrahydrofolate reductase (MTHFR) 677C.T polymorphism might increase the risk of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients (TT vs. CC: Odds ratios (ORs) = 2.75, 95% confidence intervals (95%CIs) = 1.35,5.59, P = 0.005; CT+TT vs. CC: OR = 1.39, 95%CI = 1.09,1.78, P = 0.008; TT vs. CC+CT: OR = 2.52, 95%CI = 1.25,5.09, P = 0.010; respectively)
Further subgroup analysis by ethnicity suggested that the MTHFR 677C.T polymorphism was associated with an elevated risk for CVD in ESRD patients among Asians (TT vs. CC: OR = 3.38, 95%CI = 1.11,10.28, P = 0.032; CT+TT vs. CC: OR = 1.44, 95%CI = 1.05,1.97, P = 0.022; TT vs. CC+CT: OR = 3.15, 95%CI = 1.02,9.72, P = 0.046; respectively), but not among Africans or Caucasians
Summary
Hemodialysis (HD) is a common form of dialysis therapy for kidney disease by achieving the extracorporeal removal of waste products such as creatinine, urea and free water from the blood [1]. Despite its important role in treating ESRD, HD serves as a multiplier for other vascular risk factors, contributing to an increased incidence of cardiovascular disease, such as atrial fibrillation and myocardial ischemia [3,4]. It has been reported that mortality caused by cardiovascular disease (CVD) in ESRD patients is 25% higher than that in the general population [5,6]. CVD refers to any disease that affects the cardiovascular system, principally cardiac disease, vascular diseases of the brain and kidney, and peripheral arterial disease [8].
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