Association between TNF-α polymorphisms and gestational diabetes mellitus: a meta-analysis and trial sequential analysis

Abstract

Aim

Previous studies have yielded controversial results about the link between tumor necrosis factor-α (TNF-α) gene polymorphisms (rs1800629, rs361525, and rs1799724) and risk of gestational diabetes mellitus (GDM). Thus, a meta-analysis was performed to obtain a more conclusive result.

Materials and methods

Eligible studies were retrieved in PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases on February 18 2020. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized to evaluate the relationship between TNF-α polymorphisms and GDM susceptibility in five genetic models. The subgroup stratified analysis and trial sequential analysis (TSA) were both performed.

Results

In total, 15 studies on TNF-α polymorphism including 1289 GDM patients and 1445 healthy women were identified. For rs1800629, significant associations were found in Asian subgroup in five genetic models (for example: allele model, p = .001, OR = 2.20, 95% CI = 1.38–3.52). The existing samples were adequate revealed by TSA, which reached a shred of solid evidence. No association was observed between TNF-α rs361525 and rs1799724 polymorphisms with the GDM risk within all genetic models (p > .05).

Conclusions

For Asian populations, TNF-α rs1800629 is a risk factor for GDM. There was no association between two TNF-α polymorphisms (rs361525 and rs1799724) and GDM under all genetic models. More multi-ethnic and larger sample size studies are needed to confirm these null associations.

摘要

目的：关于肿瘤坏死因子-α(TNF-α)基因多态性(rs1800629、rs361525和rs1799724)与妊娠期糖尿病(GDM)的关系, 以往的研究结果存在争议。因此, 进行了荟萃分析以获得更具说服力的结果。材料和方法：应用计算机检索PubMed、Embase、中国知识基础设施工程和万方数据库至2020年2月18日符合条件的研究。采用95%可信区间(CI)的优势比(OR)评价5种遗传模型中TNF-α基因多态性与GDM易感性的关系。采用亚组分层分析和试验序贯分析(TSA)。结果：总共有15项关于TNF-α多态性的研究, 包括1289例妊娠期糖尿病患者和1445名健康女性。Rs1800629在亚洲亚组中有5种遗传模式(如等位基因模型, p = .001, OR = 2.20, 95%CI = 1.38-3.52)。TSA对现有样本进行了充分的分析, 得出了一丝确凿的证据。在所有遗传模型中, 未观察到TNF-α rs361525和rs1799724多态性与妊娠期糖尿病风险相关(p>0.05)。结论：对于亚洲人群, TNF-α rs1800629是GDM的危险因素。在所有遗传模式下, TNF-α两个多态性(rs361525和rs1799724)与妊娠期糖尿病无关联。需要更多多种族和更大样本量的研究来证实这些无效关联。

Keywords:

• Tumor necrosis factor-α
• Polymorphisms
• Gestational diabetes mellitus
• Meta-analysis
• Trial sequential analysis

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (No. 81871173).