Tumor necrosis factor-α −308 G/A polymorphism and risk of sepsis, septic shock, and mortality: an updated meta-analysis
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Hao Wang1,*, Shujin Guo2,*, Chun Wan1,*, Ting Yang1, Ni Zeng1, Yanqiu Wu1, Lei Chen1, Yongchun Shen1 and Fuqiang Wen1
1Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
2Internal Medicine of Sichuan Provincial People's Hospital and Sichuan Academy of Medical Science, Chengdu 610072, China
*These authors contributed equally to this work
Yongchun Shen, email: firstname.lastname@example.org
Fuqiang Wen, email: email@example.com
Keywords: sepsis, mortality, polymorphism, meta-analysis
Received: June 28, 2017 Accepted: August 27, 2017 Published: September 13, 2017
Background: The -308G/A polymorphism in the gene encoding tumor necrosis factor-α (TNF-α) has been implicated in sepsis risk in many studies but with variable results. This study aimed to comprehensively assess the evidence of association between this polymorphism and risk of sepsis and sepsis-related mortality.
Materials and Methods: PubMed, EMBASE and other databases were searched to identify relevant studies, and data were analyzed using Review Manager 5.0 and STATA 12.0.
Results: Data from 34 publications involving 12,284 subjects were meta-analyzed. Combined analysis revealed an association between TNF-α -308G/A gene polymorphism and risk of sepsis (AA+GA vs. GG, OR 1.35, 95% CI 1.10–1.67, P = 0.005). This association was observed in the Caucasian subgroup (OR 1.50, 95% CI 1.13–2.00, P = 0.006), but not in the Asian subgroup. Across the entire study population, the polymorphism was also significantly related to septic shock risk (OR 1.52, 95% CI 1.18–1.95, P = 0.001) but not to sepsis-related mortality (OR 0.99, 95% CI 0.71–1.40, P = 0.97).
Conclusions: This meta-analysis suggests that the -308G/A gene polymorphism in the TNF-α gene may contribute to risk of sepsis and septic shock, but not risk of mortality.
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