Abstract
BackgroundThe association between polymorphism 4b/a, T-786C and G894T in endothelial NO synthase gene (eNOS) and ischemic stroke (IS) remains controversial in Asian. A meta-analysis was performed to better clarify the association between eNOS gene and IS risk.MethodsBased on the search of PubMed, Web of Science (ISI), CNKI (National Knowledge Infrastructure), Wan Fang Med Online and CBM (Chinese Biology Medical Literature Database) databases, all eligible case-control or cohort studies were identified. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) from fixed and random effect models were calculated. Heterogeneity among studies was evaluated using the I2. Meta-regression was used to explore the potential sources of between-study heterogeneity. Begg's test was used to estimate publication bias.ResultsOur study included 27 articles, contained 28 independent case–control studies, involved a total of 3,742 cases and 3,691 controls about 4b/a, 1,800 cases and 1,751 controls about T-786C and 2,747 cases and 2,872 controls about G894T. A significant association of 4a allele with increased risk of IS was found in dominant (FEM: OR = 1.498, 95% CI = 1.329–1.689), recessive (FEM: OR = 2.132, 95% CI = 1.383–3.286) and codominant (REM: OR = 1.456, 95% CI = 1.235–1.716) models. For T-786C and G894T, there were significant associations with dominant and codominant genetic models, but not with recessive genetic model.ConclusionsThe meta-analysis indicated that eNOS gene 4b/a, T-786C, G894T polymorphism might be associated with IS.
Highlights
Stroke is a major cause of morbidity and mortality worldwide [1,2]
We reviewed the references cited in the studies and review articles to identify additional studies not captured by our database searches
Inclusion criteria The inclusion criteria were as follows: (1) case-control or cohort study published as original study to evaluate the association between (4b/a, G894T and T-786C) polymorphisms in endothelial Nitric oxide (NO) synthase gene (eNOS) gene and risk of ischemic stroke (IS) in Asian; (2) Neuroimaging (computed tomography (CT) or magnetic resonance imaging (MRI)) was used to confirm the diagnosis of IS; (3) numbers were reported in case and control groups for case-control studies, or exposed and unexposed groups for cohort studies for each genotype, or data provided from which numbers could be calculated; (4) subjects in each study should come from the same ethnicity and period; (5)Subjects.18 years age
Summary
About 83% of strokes are ischemic stroke [3]. Large epidemiological studies have shown that stroke has a genetic predisposition. Duggirala et al thought that the proportion of genetic factors in the occurrence of stroke was about 66.0%– 74.9% [5] and almost 80% of strokes are ischemic in origin [6]. NO is synthesized by the nitric oxide synthase (NOS) isoenzymes gene, of which three major NOS forms were described: endothelial (eNOS), neuronal (nNOS), and cytokine-inducible (iNOS). The participation of the eNOS gene in the physiology of the vasculature makes it a biologically plausible candidate for study as a susceptibility gene for ischemic stroke [10]. The association between polymorphism 4b/a, T-786C and G894T in endothelial NO synthase gene (eNOS) and ischemic stroke (IS) remains controversial in Asian. A meta-analysis was performed to better clarify the association between eNOS gene and IS risk
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