Abstract
Background: Chronic kidney disease (CKD) is a public health issue, and an independent risk factor for cardiovascular disease. The peroxisome proliferator-activated receptor gamma (PPARG) plays an important role in the cardiovascular system. Previous studies have examined one important exon polymorphism, Pro12Ala, in PPARG with respect to mortality of CKD patients, but the results were inconsistent and current evidence is insufficient to support a strong conclusion. This study aimed to examine the correlation between Pro12Ala gene polymorphism and mortality among Asians with CKD by trial sequential analysis (TSA). Methods: The research was divided into observational research and meta-analysis. For the cohort study, 767 subjects from dialysis centers in Taipei were selected as samples, and tracked from December 2015 to February 2017. For the meta-analysis, relevant literature from “PubMed” and “Embase” databases (until December 2016), was searched and TSA was used to verify the results. In order to achieve the best evidence hierarchies, our retrospective cohort study was added to the meta-analysis and the TSA. Results: The combined sample size for Asian was 1,685 after adding our cohort study, and there was no significant correlation between PPARG Pro12Ala and mortality by the allele model (RR: 0.85, 95% CI: 0.39–1.83, I2 = 79.3%). Under the parameter setting with the RR value of 1.5, TSA estimation presented that the cumulative sample size entered into the futility area, and it confirmed the conclusion in this study. Conclusion: We found that PPARG Pro12Ala gene polymorphism was not related to mortality in CKD Asians patients, and validated our conclusion using TSA after adding our sample.
Highlights
Chronic kidney disease (CKD) is a public health issue around the globe with a prevalence of approximately 10% (Coresh et al, 2007)
This study aimed to examine the correlation between Pro12Ala gene polymorphism and mortality among Asians with CKD by trial sequential analysis (TSA)
The combined sample size for Asian was 1,685 after adding our cohort study, and there was no significant correlation between peroxisome proliferator-activated receptor gamma (PPARG) Pro12Ala and mortality by the allele model (RR: 0.85, 95% CI: 0.39–1.83, I2 = 79.3%)
Summary
Chronic kidney disease (CKD) is a public health issue around the globe with a prevalence of approximately 10% (Coresh et al, 2007). Compared with the general population, patients with CKD have a higher risk of cardiovascular diseases and mortality (Imai et al, 2009). The probability of death in patients with CKD is 8–10 times higher than the general population and increases with renal dysfunction (Zhang et al, 2012a). It is critical to assess CKD-related gene polymorphisms in reducing the risk of death. PPARG dysfunction may lead to a decline in kidney function, so PPARG Pro12Ala polymorphism may be associated with a risk of death in patients with CKD. Chronic kidney disease (CKD) is a public health issue, and an independent risk factor for cardiovascular disease. Previous studies have examined one important exon polymorphism, Pro12Ala, in PPARG with respect to mortality of CKD patients, but the results were inconsistent and current evidence is insufficient to support a strong conclusion. This study aimed to examine the correlation between Pro12Ala gene polymorphism and mortality among Asians with CKD by trial sequential analysis (TSA)
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