title: Meta-analysis of association between the +49A/G polymorphism of cytotoxic T-lymphocyte antigen-4 and thyroid associated ophthalmopathy.
abstract: OBJECTIVE
  Cytotoxic-T lymphocyte antigen-4 (CTLA-4) has been shown to play an important role in the development and progression of thyroid associated ophthalmopathy (TAO). A number of case-control studies focused on the association between CTLA-4 +49A/G polymorphism and risk for TAO. But the results were not always consistent. So we performed a meta-analysis to evaluate the precise association between this polymorphism and risk for TAO.
  
  
  METHODS
  All publications on the association between CTLA-4 +49A/G polymorphism and TAO were searched in the following electronic databases: PubMed, Embase, the Cochrane library and Chinese Biomedical Literature Database, with the last report up to May 2014. This meta-analysis was assessed by Review Manager 5.1.
  
  
  RESULTS
  A total of 14 studies were involved in this meta-analysis, including 1128 cases and 2539 controls. Overall, we found a significant association between CTLA-4 +49A/G polymorphism and TAO (G versus A: OR = 1.64, 95% CI = 1.40-1.92, p < 0.00001; GG versus AG + AA: OR = 2.02, 95% CI = 1.59-2.57, p < 0.00001; GG + AG versus AA: OR = 2.01, 95% CI = 1.66-2.43, p < 0.00001; GG versus AA: OR = 2.74, 95% CI = 1.83-4.10, p < 0.00001; AG versus AA: OR = 1.75, 95% CI = 1.42-2.15, p < 0.00001). The results were not materially altered after the studies which did not fulfill Hardy-Weinberg equilibrium were excluded. Significant association was also detected in both Caucasian and Asian populations in subgroup analysis divided by different ethnicity.
  
  
  CONCLUSIONS
  Our meta-analysis supports the association between the CTLA-4 +49A/G polymorphism and TAO.
authors.affiliation: a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China and.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: b Department of Transfusion Medicine , Shanghai Changhai Hospital, Second Military Medical University , Shanghai , China.
authors.forename: Li-Shuang
authors.initials: LS
authors.lastname: Zhu
authors.affiliation: a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China and.
authors.forename: Jin-Wei
authors.initials: JW
authors.lastname: Cheng
authors.affiliation: a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China and.
authors.forename: Ji-Ping
authors.initials: JP
authors.lastname: Cai
authors.affiliation: a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China and.
authors.forename: You
authors.initials: Y
authors.lastname: Li
authors.affiliation: a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China and.
authors.forename: Xiao-Ye
authors.initials: XY
authors.lastname: Ma
authors.affiliation: a Department of Ophthalmology , Shanghai Changzheng Hospital, Second Military Medical University , Shanghai , China and.
authors.forename: Rui-Li
authors.initials: RL
authors.lastname: Wei
mesh_terms: D060908:CTLA-4 Antigen / Q000235:genetics*; D016208:Databases, Factual; D049970:Graves Ophthalmopathy / Q000235:genetics*; D006801:Humans; D020641:Polymorphism, Single Nucleotide
chemical_list: D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human
keywords: Cytotoxic T-lymphocyte antigen-4; polymorphism; thyroid-associated ophthalmopathy