| Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 106 === Introduction:
The prevalence of Chronic Kidney Disease (CKD) in Taiwan is 11.9%, and the incidence and prevalence of End Stage Renal Disease (ESRD) are among the highest in the world (455, 3219 per million people, respectively). The dialysis treatment for ESRD patients can cause loss of quality of life and economic burden. Currently known chronic kidney disease risk factors including: genetic inheritance, hypertension, hyperlipidemia, diabetes, etc. Some studies indicated that the polymorphism of nitric oxide synthase T-786C affects the concentration of nitric oxide in the body, which causes endothelial dysfunction, thus increases the risk of diabetes and hypertension and CKD. However, other studies showed that the gene polymorphism was not associated with CKD risk.
This meta-analysis will combine our case-control samples and previous literature samples to explore the relevance of T-786C polymorphism and CKD risk.
Method:
This study was divided into two parts: case-control study and meta-analysis study. 558 samples from six dialysis centers of Taipei were selected as case group of case-control study, and 640 samples from Tri-Service General Hospital elderly health checkup were selected as control group of case-control study. This study will analyze differences in the distribution of eNOS T-786C polymorphism between patients with dialysis and healthy populations, and understanding the risk factors of hemodialysis. Meta-analysis will search Pubmed, Embase for related literatures, and combine case-control study results with published samples to explore the revelance of eNOS T-786C polymorphism and chronic kidney disease risk. Besides, this study will use Trial Sequential analysis to explore whether the sample size can prove the revelance between T-786C and CKD.
Result:
This meta-analysis included twelve studies, and found there was significant correlation between T-786C and CKD in overall population(Dominant: OR = 1.22(95%CI: 1.04-1.42) , Allele: OR = 1.20(95%CI: 1.06-1.35), Recessive: OR = 1.41(95%CI: 1.07-1.86) ).This study divided population into Asian samples and Caucasians,and found there was significant correlation between T-786C and CKD in Caucasians, but not in Asians. Furthermore, the sample size were insufficient (n = 2305) in Asians, but after adding our sample (n = 1198), the TSA cumulative sample (n = 3503) entered the futility area that can prove T-786C and CKD not relevant in Asian. In addition, this study found diabetes prevalence had interaction on revelance between T-786C and CKD.
Conclusion:
We found that eNOS T-786C gene polymorphism was not related to CKD among Asian, after adding our sample, we can prove there was no revelance between eNOS T-786C and CKD.
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