Association between Apolipoprotein E Gene Polymorphism and the Risk of Coronary Artery Disease in Chinese Population: Evidence from a Meta-Analysis of 40 Studies

BackgroundEpidemiological studies have evaluated the association between apolipoprotein E (ApoE) gene polymorphism and coronary artery disease (CAD) risk which developed inconsistent conclusions. To derive a more precise estimation of the relationship in Chinese population, we performed this meta-analysis.MethodsDatabases, including PubMed, EMbase, Web of Science, CBMdisc and CNKI, were searched to get the genetic association studies. Additionally, hand searching of the references of identified articles were performed. All the statistical tests were performed using Review Manager 5.1.2 and Stata 11.0.ResultsWe identified a total of 40 studies, including 4,564 CAD cases and 3,985 controls. The results showed evidence for significant association between ApoE ε4 allele and CAD risk (for ε2/ε4 vs. ε3/ε3: OR = 1.86, 95% CI = 1.42–2.43, pConclusionsThe present meta-analysis suggests an association between ApoE ε4 allele and increased risk of CAD in Chinese population. However, due to the small sample size in most of the included studies and the selection bias existed in some studies, the results should be interpreted with caution.

背景：既往流行病学研究曾探讨载脂蛋白E（apolipoprotein E, ApoE）基因多态性与冠状动脉疾病（coronary artery disease, CAD）风险的关联，但所得结论不尽一致。为精准评估中国人群中二者的关联，本研究开展此项荟萃分析。
方法：通过检索PubMed、EMbase、Web of Science、CBMdisc及CNKI等数据库，获取相关遗传学关联研究；同时对已纳入文献的参考文献进行手工检索。所有统计学检验均采用Review Manager 5.1.2及Stata 11.0软件完成。
结果：本研究共纳入40项相关研究，合计包含4564例冠状动脉疾病患者及3985例对照。结果显示，载脂蛋白E ε4等位基因与冠状动脉疾病风险存在显著关联（ε2/ε4基因型 vs ε3/ε3基因型：OR=1.86，95%CI=1.42~2.43，P）。
结论：本项荟萃分析结果表明，中国人群中载脂蛋白E ε4等位基因与冠状动脉疾病风险升高存在关联。但由于纳入研究大多样本量较小，且部分研究存在选择偏倚，因此对本研究结果的解读需谨慎。