Association between TNF-<i>α</i> Gene -308G/A Polymorphism and the Risk of Endometriosis: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 GONGQing ¹ , LISheng ² , HUANGJing-yu ² ,  WENGHong ²

1. Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China;
2. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China;

Corresponding?author：

WENGHong, Email: wengh92@163.com

Keywords：

Endometriosis; TNF-α; -308G/A; Polymorphism; Meta-analysis

DOI：

10.7507/1672-2531.20160010

Video：

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Objective To evaluate the association between tumor necrosis factor alpha (TNF-α) gene -308G/A polymorphism and the risk of endometriosis (EM). Methods Databases including PubMed, EMbase, CBM, CNKI, VIP, and WanFang Data were searched to collect case-control studies about the association between TNF-α gene -308G/A polymorphism and the risk of EM from inception to October 2014. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then Meta-analysis was performed by using Stata 12.0 software. Results A total of seven case-control studies were included, which involved 687 patients and 877 controls. The results of meta-analysis showed that, AA genotype carriers presented 2.06-fold (OR=2.06, 95%CI 1.10 to 3.83, P=0.02) and 1.94-fold (OR=1.94, 95%CI 1.18 to 3.18, P<0.01) higher risk of EM than GG genotype carriers and AG+GG genotype carriers, respectively; but sensitivity analysis showed that the robustness of these results was unstable. No statistical significance was found in the allele model, co-dominant model, and dominant model (A vs. G: OR=1.37, 95%CI 0.87 to 2.17, P=0.18; AG vs. GG: OR=1.09, 95%CI 0.77 to 1.53, P=0.63; AA+AG vs. GG: OR=1.29, 95%CI 0.95 to 1.77, P=0.11). While excluding studies that controls were not in HWE, no significant association was observed in these five genetic models; and no significant association was found in the results of subgroup analysis by ethnicity. Conclusion The AA genotype of TNF-α gene -308G/A polymorphism might contribute to the risk of EM, but the association between other genotypes and EM susceptibility is unclear. In addition, due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.

Citation： GONGQing, LISheng, HUANGJing-yu, WENGHong. Association between TNF-α Gene -308G/A Polymorphism and the Risk of Endometriosis: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(1): 41-47. doi: 10.7507/1672-2531.20160010 Copy

1.	Ilangavan K, Kalu E. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners. Fertil Steril, 2010, 93(3): e10, e12.
2.	郎景和. 以轉化醫學的觀念促進子宮內膜異位癥的研究. 國際婦產科學雜志, 2011, 38(4): 261-262.
3.	Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod, 2014, 29(3): 400-412.
4.	Kennedy S, Bergqvist A, Chapron C, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod, 2005, 20(10): 2698-2704.
5.	曾憲濤, 李勝, 馬鉆, 等. Meta分析系列之八: Meta分析的報告規范. 中國循證心血管醫學雜志, 2012, 4(6): 500-503.
6.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
7.	Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA, 2000, 283(15): 2008-2012.
8.	曾憲濤, Joey S. W. Kwong, 田國祥, 等. Meta分析系列之二: Meta分析的軟件. 中國循證心血管醫學雜志, 2012, 4(2): 89-91.
9.	Hsieh YY, Chang CC, Tsai FJ, et al. Polymorphisms for interleukin-4 (IL-4) -590 promoter, IL-4 intron3, and tumor necrosis factor alpha -308 promoter: non-association with endometriosis. J Clin Lab Anal, 2002, 16(3): 121-126.
10.	Lee MK, Park AJ, Kim DH. Tumor necrosis factor-alpha and interleukin-6 promoter gene polymorphisms are not associated with an increased risk of endometriosis. Fertil Steril, 2002, 77(6): 1304-1305.
11.	Wieser F, Fabjani G, Tempfer C, et al. Tumor necrosis factor-alpha promotor polymorphisms and endometriosis. J Soc Gynecol Investig, 2002, 9(5): 313-318.
12.	Ashgar T, Yoshida S, Kennedy S, et al. The tumor necrosis factor-(alpha) promoter -1031C polymorphism is associated with decreased risk of endometriosis in Japanese population. Hum Reprod, 2004, 19(11): 2509-2514.
13.	羅敏, 申東翔, 張宏斌, 等. 子宮內膜異位癥與腫瘤壞死因子-α基因多態性的相關性. 廣東醫學, 2006, 27(10): 1498-1499.
14.	車坤蘭, 羅程, 何鳳儀, 等. 子宮內膜異位癥與腫瘤壞死因子TNFα-308G/A和TNFβG252A基因多態性的關系. 解剖學研究, 2010, 32(1): 21-24.
15.	曾改鴻, 王曉暉, 黃曉東, 等. 腫瘤壞死因子啟動子TNFα-238G/A、-308G/A基因多態性與子宮內膜異位癥的相關性. 中國婦幼保健, 2010, 25(30): 4441-4443.
16.	Calhaz-Jorge C, Costa AP, Barata M, et al. Tumour necrosis factor alpha concentrations in the peritoneal fluid of infertile women with minimal or mild endometriosis are lower in patients with red lesions only than in patients without red lesions. Hum Reprod, 2000, 15(6): 1256-1260.
17.	Akoum A, Lawson C, Mccoll S, et al. Ectopic endometrial cells express high concentrations of interleukin (IL)-8 in vivo regardless of the menstrual cycle phase and respond to oestradiol by up-regulating IL-1-induced IL-8 expression in vitro. Mol Hum Reprod, 2001, 7(9): 859-866.
18.	羅敏, 何援利. TNF基因多態性與子宮內膜異位癥的關系研究進展. 西北國防醫學雜志, 2006, 27(5): 372-373.
19.	毛敏, 楊勇, 曾憲濤, 等. 牙周病與冠心病發病相關性:一項基于37個病例-對照研究的Meta分析. 中國循證心血管醫學雜志, 2012, 4(5): 403-407.
20.	曾憲濤, 田國祥, 張超, 等. Meta分析系列之十五: Meta分析的進展與思考. 中國循證心血管醫學雜志, 2013, 5(6): 561-563.

1. Ilangavan K, Kalu E. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners. Fertil Steril, 2010, 93(3): e10, e12.
2. 郎景和. 以轉化醫學的觀念促進子宮內膜異位癥的研究. 國際婦產科學雜志, 2011, 38(4): 261-262.
3. Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod, 2014, 29(3): 400-412.
4. Kennedy S, Bergqvist A, Chapron C, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod, 2005, 20(10): 2698-2704.
5. 曾憲濤, 李勝, 馬鉆, 等. Meta分析系列之八: Meta分析的報告規范. 中國循證心血管醫學雜志, 2012, 4(6): 500-503.
6. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
7. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA, 2000, 283(15): 2008-2012.
8. 曾憲濤, Joey S. W. Kwong, 田國祥, 等. Meta分析系列之二: Meta分析的軟件. 中國循證心血管醫學雜志, 2012, 4(2): 89-91.
9. Hsieh YY, Chang CC, Tsai FJ, et al. Polymorphisms for interleukin-4 (IL-4) -590 promoter, IL-4 intron3, and tumor necrosis factor alpha -308 promoter: non-association with endometriosis. J Clin Lab Anal, 2002, 16(3): 121-126.
10. Lee MK, Park AJ, Kim DH. Tumor necrosis factor-alpha and interleukin-6 promoter gene polymorphisms are not associated with an increased risk of endometriosis. Fertil Steril, 2002, 77(6): 1304-1305.
11. Wieser F, Fabjani G, Tempfer C, et al. Tumor necrosis factor-alpha promotor polymorphisms and endometriosis. J Soc Gynecol Investig, 2002, 9(5): 313-318.
12. Ashgar T, Yoshida S, Kennedy S, et al. The tumor necrosis factor-(alpha) promoter -1031C polymorphism is associated with decreased risk of endometriosis in Japanese population. Hum Reprod, 2004, 19(11): 2509-2514.
13. 羅敏, 申東翔, 張宏斌, 等. 子宮內膜異位癥與腫瘤壞死因子-α基因多態性的相關性. 廣東醫學, 2006, 27(10): 1498-1499.
14. 車坤蘭, 羅程, 何鳳儀, 等. 子宮內膜異位癥與腫瘤壞死因子TNFα-308G/A和TNFβG252A基因多態性的關系. 解剖學研究, 2010, 32(1): 21-24.
15. 曾改鴻, 王曉暉, 黃曉東, 等. 腫瘤壞死因子啟動子TNFα-238G/A、-308G/A基因多態性與子宮內膜異位癥的相關性. 中國婦幼保健, 2010, 25(30): 4441-4443.
16. Calhaz-Jorge C, Costa AP, Barata M, et al. Tumour necrosis factor alpha concentrations in the peritoneal fluid of infertile women with minimal or mild endometriosis are lower in patients with red lesions only than in patients without red lesions. Hum Reprod, 2000, 15(6): 1256-1260.
17. Akoum A, Lawson C, Mccoll S, et al. Ectopic endometrial cells express high concentrations of interleukin (IL)-8 in vivo regardless of the menstrual cycle phase and respond to oestradiol by up-regulating IL-1-induced IL-8 expression in vitro. Mol Hum Reprod, 2001, 7(9): 859-866.
18. 羅敏, 何援利. TNF基因多態性與子宮內膜異位癥的關系研究進展. 西北國防醫學雜志, 2006, 27(5): 372-373.
19. 毛敏, 楊勇, 曾憲濤, 等. 牙周病與冠心病發病相關性:一項基于37個病例-對照研究的Meta分析. 中國循證心血管醫學雜志, 2012, 4(5): 403-407.
20. 曾憲濤, 田國祥, 張超, 等. Meta分析系列之十五: Meta分析的進展與思考. 中國循證心血管醫學雜志, 2013, 5(6): 561-563.

Chinese Journal of Evidence-Based Medicine

Association between TNF-α Gene -308G/A Polymorphism and the Risk of Endometriosis: A Meta-Analysis

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