Yıl: 2021 Cilt: 18 Sayı: 2 Sayfa Aralığı: 139 - 150 Metin Dili: İngilizce

A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?

Öz:
The associations of ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss (RPL) in Iranian women have yielded controversial results. Thus, we conducted a meta-analysis to obtain more certain results. A comprehensive literature search was performed in the PubMed, Web of Sciences, Scopus, MedRxiv, SID, and CNKI databases up to January 1st, 2021, using the appropriate terms. All case-control studies were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of associations. A total of 14 studies including eight studies with 783 patients and 761 healthy subjects on ACE I/D and six studies with 1.155 patients and 699 healthy subjects on PAI-1 4G/5G were included. Combined data revealed that ACE I/D polymorphism was significantly associated with RPL risk in Iranian women under three models i.e., allele [OR=0.744, 95% CI: (0.640-0.864); p≤0.001], dominant [OR=0.774, 95% CI: (0.601-0.996); p=0.047], and recessive [OR=0.767, 95% CI: (0.611-0.963); p=0.022]. Moreover, the pooled data showed a significant association between the PAI-1 4G/5G polymorphism and RPL risk under all five models i.e., allele [OR=2.352, 95% CI: (1.623-3.408); p≤0.001], heterozygote [OR=8.364, 95% CI: (4.744-14.756); p≤0.001), homozygote [OR=2.192, 95% CI: (1.093-4.394); p=0.027), dominant [OR=2.354, 95% CI: (1.309-4.235); p=0.004], and recessive [OR=5.208, 95% CI: (3.005-9.025); p≤0.001]. Stratification analysis revealed that these polymorphisms were associated with RPL risk by the number of miscarriages. Our pooled data indicated that ACE I/D and PAI-1 4G/5G polymorphisms were significantly associated with an increased risk of RPL in Iranian women. These significant findings showed that the investigation might be adequate for ACE I/D and PAI-1 4G/5G polymorphisms in the Iranian population.
Anahtar Kelime:

Konular:
Fen > Tıp > Kadın Hastalıkları ve Doğum

İranlı kadınlarda tekrarlayan gebelik kaybı ile ACE I/D ve PAI-1 4G/5G polimorfizmlerinin ilişkisine yönelik bir meta-analiz: Araştırmalar yeterli mi?

Öz:
İranlı kadınlarda ACE I/D ve PAI-1 4G/5G polimorfizmlerinin tekrarlayan gebelik kaybı (TGK) ile ilişkisi tartışmalı sonuçlar vermiştir. Bu yüzden, daha güvenilir sonuçlar almak için bir meta-analiz gerçekleştirdik. PubMed, Web of Sciences, Scopus, MedRxiv, SID ve CNKI veritabanlarında uygun terimler kullanılarak 01 Ocak 2021 tarihine kadar kapsamlı bir literatür taraması gerçekleştirildi. Tüm olgu kontrol çalışmaları dahil edildi. İlişkilerin gücünü tahmin etmek için olasılık oranları (OO’lar) ve %95 güven aralıkları (GA) kullanıldı. Meta-analize ACE I/D ile ilgili 783 hasta ve 761 sağlıklı denek içeren 8 çalışma ve PAI-1 4G/5G ile ilgili 1.155 hasta ve 699 sağlıklı denek içeren 6 çalışma dahil olmak üzere toplam 14 çalışma dahil edildi. Birleşik veriler, ACE I/D polimorfizminin; allel (OO=0,744, %95 GA: 0,640-0,864, p≤0,001), dominant (OO=0,774, %95 GA: 0,601-0,996, p=0,047) ve resesif (OO=0,767, %95 GA: 0,611-0,963, p=0,022) olmak üzere üç model altında İranlı kadınlarda TGK riski ile önemli ölçüde ilişkili olduğunu ortaya koymuştur. Ayrıca,havuzlanmış veriler, PAI-1 4G/5G polimorfizmi ile TGK riski arasında, beş modelin tümünde, yani allel (OO=2,352, %95 GA: 1,623-3,408, p≤0,001), heterozigot (OO=8,364, %95 GA: 4,744-14,756, p≤0,001), homozigot (OO=2,192, %95 GA: 1,093-4,394, p=0,027), dominant (OO=2,354, %95 GA: 1,309-4,235, p=0,004) ve resesif (OO=5,208, %95 GA: 3,005-9,025, p≤0,001) modellerinde anlamlı ilişkinin varlığını göstermiştir. Tabakalaşma analizi, bu polimorfizmlerin düşük sayısına göre TGK riski ile ilişkili olduğunu ortaya çıkarmıştır. Birleştirilmiş verilerimiz, ACE I/D ve PAI-1 4G/5G polimorfizmlerinin, İranlı kadınlarda artmış TGK riski ile önemli ölçüde ilişkili olduğunu gösterdi. Bu önemli bulgular bizi, İran popülasyonunda ACE I/D ve PAI-1 4G/5G polimorfizmleri açısından araştırmanın yeterli olabileceği kararına götürdü.
Anahtar Kelime:

Konular:
Fen > Tıp > Kadın Hastalıkları ve Doğum
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Aslbahar F, Neamatzadeh H, Tabatabaiee R, Karimi-Zarchi M, Javaheri A, Mazaheri M, et al. Association of angiotensin-converting enzyme insertion/deletion polymorphism with recurrent pregnancy loss: a meta-analysis of 26 case-control studies. Rev Bras Ginecol Obstet 2018;40:631-41.
  • 2. Maziri P, Tehrani GA, Hidagi FB, Nejatollahi M, Asadi S. Association between thrombophilic gene polymorphisms and recurrent pregnancy loss in iranian women. Iranian Journal of Neonatology 2017;8:13-9.
  • 3. Kamali M, Hantoushzadeh S, Borna S, Neamatzadeh H, Mazaheri M, Noori-Shadkam M, et al. Association between thrombophilic genes polymorphisms and recurrent pregnancy loss susceptibility in Iranian women: A systematic review and meta-analysis. Iran Biomed J 2018;22:78-89.
  • 4. Behforouz A, Dastgheib SA, Abbasi H, Karimi-Zarchi M, Javaheri A, Hadadan A, et al. Association of MMP-2, MMP-3, and MMP-9 polymorphisms with susceptibility to recurrent pregnancy loss. Fetal Pediatr Pathol 2020:1-9.
  • 5. Soleimani-Jadidi S, Abbasi H, Javaheri A, Behforouz A, Zanbagh L, Meibodi B, et al. Cumulative evidence for association of il-10 -1082g > a polymorphism with susceptibility to recurrent pregnancy loss: a systematic review and meta-analysis. Fetal Pediatr Pathol 2020:1-15.
  • 6. Heidari MM, Sheikholeslami M, Yavari M, Khatami M, Seyedhassani SM. The association of renin–angiotensinogen system genes polymorphisms and idiopathic recurrent pregnancy loss. Hum Fertil (Camb) 2017;22:164-70.
  • 7. Neamatzadeh H, Ramazani V, Kalantar SM, Ebrahimi M, Sheikhha MH. Serum immune reactivity against β2-Glycoprotein-I and antineutrophil cytoplasmic auto-antibodies by ELI-P-Complex Screening Technology in recurrent miscarriage. Minerva Ginecol 2016;68:243-9.
  • 8. Colucci G, Tsakiris DA. Thrombophilia screening revisited: an issue of personalized medicine. J Thromb Thrombolysis 2020;49:618-29.
  • 9. Simcox LE, Ormesher L, Tower C, Greer IA. Thrombophilia and pregnancy complications. Int J Mol Sci 2015;16:28418-28. doi:10.3390/ijms161226104.
  • 10. Ormesher L, Simcox L, Tower C, Greer IA. Management of inherited thrombophilia in pregnancy. Womens Health (Lond) 2016;12:433-41.
  • 11. Nassour-Mokhtari I, Loukidi B, Moussouni A, Bettioui R, Benhabib R, Merzouk H, et al. Inherited thrombophilia and recurrent pregnancy loss: a single-center case-control study in North-Western Algeria. Egyptian J Med Hum Genet 2020;21:1-7.
  • 12. Huang Z, Tang W, Liang Z, Chen Q, Li M, Li Y, et al. Plasminogen activator inhibitor-1 polymorphism confers a genetic contribution to the risk of recurrent spontaneous abortion: an updated meta-analysis. Reprod Sci 2017;24:1551-60.
  • 13. Vaiman D. Genetic regulation of recurrent spontaneous abortion in humans. Biomed J 2015;38:11-24.
  • 14. Hemsworth EM, O’Reilly AM, Allen VM, Kuhle S, Brock JK, Knowledge Synthesis Group on Determinants of Preterm/LBW Births. Association between factor v leiden mutation, small for gestational age, and preterm birth: a systematic review and meta-analysis. J Obstet Gynaecol Can 2016;38:897-908.
  • 15. Chatzidimitriou M, Chatzidimitriou D, Mavridou M, Anetakis C, Chatzopoulou F, Lialiaris T, et al. Thrombophilic gene polymorphisms and recurrent pregnancy loss in Greek women. Int J Lab Hematol 2017;39:590-5.
  • 16. Shi X, Xie X, Jia Y, Li S. Maternal genetic polymorphisms and unexplained recurrent miscarriage: a systematic review and metaanalysis. Clin Genet 2017;91:265-84.
  • 17. Walker ID. Thrombophilia in pregnancy. J Clin Pathol 2000;53:573- 80.
  • 18. Shakarami F, Akbari MT, Zare Karizi S. Association of plasminogen activator inhibitor-1 and angiotensin converting enzyme polymorphisms with recurrent pregnancy loss in Iranian women. Iran J Reprod Med 2015;13:627-32.
  • 19. Ranellou K, Paraskeva A, Kyriazopoulos P, Batistatou A, Evangelou A, El-Aly M, et al. Polymorphisms in prothrombotic genes in young stroke patients in Greece: a case-controlled study. Blood Coagul Fibrinolysis 2015;26:430-5.
  • 20. Li Y, Liu F-X, Yuan C, Meng L. Association between plasminogen activator inhibitor gene polymorphisms and osteonecrosis of the femoral head susceptibility. Medicine (Baltimore) 2017;96:e7047. doi:10.1097/MD.0000000000007047.
  • 21. Sobhan MR, Mahdinezhad-Yazdi M, Moghimi M, Aghili K, Jafari M, Zare-Shehneh M, et al. Plasminogen activator inhibitor-1 4g/5g polymorphism contributes to osteonecrosis of the femoral head susceptibility: evidence from a systematic review and meta-analysis. Arch Bone Jt Surg 2018;6:468-77.
  • 22. Dastgheib SA, Najafi F, Shajari A, Bahrami R, Asadian F, Sadeghizadeh-Yazdi J, et al. Association of plasminogen activator inhibitor-1 4G5G polymorphism with risk of diabetic nephropathy and retinopathy: a systematic review and meta-analysis. J Diabetes Metab Disord 2020;19:2005-16
  • 23. Jafari M, Jarahzadeh MH, Dastgheib SA, Seifi-Shalamzari N, RaeeEzzabadi A, Sadeghizadeh-Yazdi J, et al. Association of PAI-1 rs1799889 polymorphism with susceptibility to ischemic stroke: a huge meta-analysis based on 44 studies. Acta Medica (Hradec Kralove) 2020;63:31-42.
  • 24. Nie W, Li B, Xiu Q. The -675 4G/5G polymorphism in plasminogen activator inhibitor-1 gene is associated with risk of asthma: a meta-analysis. PLoS One. 2012;7:e34385. doi:10.1371/journal. pone.0034385.
  • 25. Ye Y, Vattai A, Zhang X, Zhu J, Thaler CJ, Mahner S, et al. Role of plasminogen activator inhibitor type 1 in pathologies of female reproductive diseases. Int J Mol Sci 2017;18:1651.
  • 26. Moghimi M, Kargar S, Jafari MA, Ahrar H, Jarahzadeh MH, Neamatzadeh H, et al. Angiotensin converting enzyme insertion/ deletion polymorphism is associated with breast cancer risk: a metaanalysis. Asian Pac J Cancer Prev 2018;19:3225-31.
  • 27. El Sharkawy RM, Zaki AM, El Fattah Kamel AA, Bedair RN, Ahmed AS. Association between the polymorphisms of angiotensin converting enzyme (Peptidyl-Dipeptidase A) INDEL mutation (I/D) and Angiotensin II type I receptor (A1166C) and breast cancer among post menopausal Egyptian females. Alexandria J Med 2014;50:267- 74.
  • 28. Sun M, Liu C, Wei F, Zhong J, Sun Y. Association of angiotensin I converting enzyme insertion/deletion polymorphism with breast cancer: a meta-analysis. J Renin Angiotensin Aldosterone Syst 2011;12:611-6.
  • 29. Fazelnia S, Farazmandfar T, Hashemi-Soteh SMB. Significant correlation of angiotensin converting enzyme and glycoprotein IIIa genes polymorphisms with unexplained recurrent pregnancy loss in north of Iran. Int J Reprod Biomed 2016;14:323-8.
  • 30. Azin SA, Golbabaei F, Warmelink JC, Eghtedari S, Haghani S, Ranjbar F. Association of depression with sexual function in women with history of recurrent pregnancy loss: descriptive-correlational study in Tehran, Iran. Fertil Res Pract 2020;6:21.
  • 31. Bigdeli R, Younesi MR, Panahnejad E, Asgary V, Heidarzadeh S, Mazaheri H, et al. Association between thrombophilia gene polymorphisms and recurrent pregnancy loss risk in Iranian women. Syst Biol Reprod Med 2018;64:274-82.
  • 32. Soltanghoraee H, Memariani T, Aarabi M, Hantoushzadeh S, Arefi S, Aarabi M, et al. Association of ACE, PAI-1 and coagulation factor XIII gene polymorphisms with recurrent spontaneous abortion in Iranian patients. J Reprod Infertil 2007;7:324-30.
  • 33. Bagheri M, Abdi Rad I, Omrani MD, Nanbaksh F. Polymorphisms of the angiotensin converting enzyme gene in Iranian Azeri Turkish women with unexplained recurrent pregnancy loss. Hum Fertil (Camb) 2010;13:79-82.
  • 34. Aarabi M, Memariani T, Arefi S, Aarabi M, Zadeh SH, Akhondi MA, et al. Polymorphisms of plasminogen activator inhibitor-1, angiotensin converting enzyme and coagulation factor XIII genes in patients with recurrent spontaneous abortion. J Matern Fetal Neonatal Med 2011;24:545-8.
  • 35. Poursadegh Zonouzi A, Chaparzadeh N, Ghorbian S, Sadaghiani MM, Farzadi L, Ghasemzadeh A, et al. The association between thrombophilic gene mutations and recurrent pregnancy loss. J Assist Reprod Genet 2013;30:1353-9.
  • 36. Jeddi-Tehrani M, Torabi R, Zarnani AH, Mohammadzadeh A, Arefi S, Zeraati H, et al. Analysis of plasminogen activator inhibitor-1, integrin beta3, beta fibrinogen, and methylenetetrahydrofolate reductase polymorphisms in iranian women with recurrent pregnancy loss. Am J Reprod Immunol 2011;66:149-56.
  • 37. Idali F, Zareii S, Mohammad-Zadeh A, Reihany-Sabet F, AkbarzadehPasha Z, Khorram-Khorshi H-R, et al. Plasminogen activator inhibitor 1 and methylenetetrahydrofolate reductase gene mutations in iranian women with polycystic ovary syndrome. Am J Reprod Immunol 2012;68:400-7.
  • 38. Khosravi F, Zarei S, Ahmadvand N, Akbarzadeh-Pasha Z, Savadi E, Zarnani A-H, et al. Association between plasminogen activator inhibitor 1 gene mutation and different subgroups of recurrent miscarriage and implantation failure. J Assist Reprod Genet 2014;31:121-4.
  • 39. Aslebahar F, Neamatzadeh H, Meibodi B, Karimi-Zarchi M, Tabatabaei RS, Noori-Shadkam M, et al. Association of Tumor Necrosis Factor-α (TNF-α) -308G>A and -238G>A Polymorphisms with Recurrent Pregnancy Loss Risk: A Meta-Analysis. Int J Fertil Steril 2019;12:284- 92.
  • 40. Margaglione M, Cappucci G, Colaizzo D, Giuliani N, Vecchione G, Grandone E, et al. The PAI-1 gene locus 4g/5G polymorphism is associated with a family history of coronary artery disease. Arterioscler Thromb Vasc Biol 1998;18:152-6.
  • 41. Wolf CE, Haubelt H, Pauer HU, Hinney B, Krome-Cesar C, Legler TJ, et al. Recurrent pregnancy loss and its relation to FV Leiden, FII G20210A and polymorphisms of plasminogen activator and plasminogen activator inhibitor. Pathophysiol Haemost Thromb 2003;33:134-7.
  • 42. Al Sallout RJ, Sharif FA. Polymorphisms in NOS3, ACE and PAI-1 genes and risk of spontaneous recurrent miscarriage in the gaza strip. Med Princ Pract 2010;19:99-104.
  • 43. Ozdemir O, Yenicesu GI, Silan F, Köksal B, Atik S, Ozen F,et al. Recurrent pregnancy loss and its relation to combined parental thrombophilic gene mutations. Genet Test Mol Biomarker 2012;16:279-86.
  • 44. Adler G, Mahmutbegovic E, Valjevac A, Adler MA, Mahmutbegovic N, Safranow K, et al. Association between - 675 ID, 4G/5G PAI-1 gene polymorphism and pregnancy loss: a systematic review. Acta Inform Med 2018;26:156-9.
  • 45. Liu Y, Liu Y, Zhang R, Tan J, Chen L, Liu Y. Meta-analysis of the association between plasminogen activator inhibitor-1 4g/5g polymorphism and recurrent pregnancy loss. Med Sci Monit 2015;21:1051-6.
  • 46. Gumus E. The powerful association of angiotensin-converting enzyme insertion/deletion polymorphism and idiopathic recurrent pregnancy loss. Ginekol Pol 2018;89:573-6.
  • 47. Wang Z, Wang P, Wang X, He X, Wang Z, Xu D, et al. Significant association between angiotensin-converting enzyme gene insertion/ deletion polymorphism and risk of recurrent miscarriage: a systematic review and meta-analysis. Metabolism 2013;62:1227-38.
  • 48. Pereza N, Ostojić S, Zdravčević M, Volk M, Kapović M, Peterlin B. Insertion/deletion polymorphism intron 16 of ACE gene in idiopathic recurrent spontaneous abortion: case-control study, systematic review and meta-analysis. Reprod Biomed Online 2016;32:237-46.
  • 49. Su MT, Lin SH, Chen YC, Kuo PL. Genetic association studies of ACE and PAI-1 genes in women with recurrent pregnancy loss: a systematic review and meta-analysis. Thrombos Haemost 2013;109:8-15.
APA DASTGHEİB S, KARIMI-ZARCHI M, BAHRAMİ R, TABATABAEİ R, JAVAHERİ A, NOORİSHADKAM M, MİRJALİLİ S, NEAMATZADEH H (2021). A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?. Turkish Journal of Obstetrics and Gynecology, 18(2), 139 - 150.
Chicago DASTGHEİB Seyed Alireza,KARIMI-ZARCHI Mojgan,BAHRAMİ Reza,TABATABAEİ Razieh Sadat,JAVAHERİ Atiyeh,NOORİSHADKAM Mahmood,MİRJALİLİ Seyed Reza,NEAMATZADEH Hossein A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?. Turkish Journal of Obstetrics and Gynecology 18, no.2 (2021): 139 - 150.
MLA DASTGHEİB Seyed Alireza,KARIMI-ZARCHI Mojgan,BAHRAMİ Reza,TABATABAEİ Razieh Sadat,JAVAHERİ Atiyeh,NOORİSHADKAM Mahmood,MİRJALİLİ Seyed Reza,NEAMATZADEH Hossein A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?. Turkish Journal of Obstetrics and Gynecology, vol.18, no.2, 2021, ss.139 - 150.
AMA DASTGHEİB S,KARIMI-ZARCHI M,BAHRAMİ R,TABATABAEİ R,JAVAHERİ A,NOORİSHADKAM M,MİRJALİLİ S,NEAMATZADEH H A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?. Turkish Journal of Obstetrics and Gynecology. 2021; 18(2): 139 - 150.
Vancouver DASTGHEİB S,KARIMI-ZARCHI M,BAHRAMİ R,TABATABAEİ R,JAVAHERİ A,NOORİSHADKAM M,MİRJALİLİ S,NEAMATZADEH H A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?. Turkish Journal of Obstetrics and Gynecology. 2021; 18(2): 139 - 150.
IEEE DASTGHEİB S,KARIMI-ZARCHI M,BAHRAMİ R,TABATABAEİ R,JAVAHERİ A,NOORİSHADKAM M,MİRJALİLİ S,NEAMATZADEH H "A meta-analysis of the association of the ACE I/D and PAI-1 4G/5G polymorphisms with recurrent pregnancy loss in Iranian women: Are the investigations adequate?." Turkish Journal of Obstetrics and Gynecology, 18, ss.139 - 150, 2021.