Associations between endothelial nitric oxide synthase polymorphisms and risk of diabetic nephropathy: an updated meta-analysis.
BACKGROUND
Genetic polymorphism of endothelial nitric oxide synthase (eNOS) has been implicated in the risk of diabetic nephropathy (DN), but the published findings were inconsistent. We performed a comprehensive meta-analysis to derive a more precise estimation of the association between genetic polymorphisms of eNOS and the risk of DN.


METHODS
Six online database were researched on the associations between polymorphisms of eNOS (T786C, G894T, 4b/4a) and DN risk. PRISMA statement and Hardy-Weinberg equilibrium assessment were used in this report. Odds ratio and 95% confidence interval were estimated based on the following genetic contrast/models: allelic model, dominant model, recessive model and co-dominant model. The publication bias and sensitivity analysis were also performed to guarantee the statistical power.


RESULTS
A total of 49 case-control studies with 11,990/9754/5131 participants for DN/DM/HC group were eligible for meta-analysis (7/25/31 studies for T786C/G984T/4b/a). For the eNOS-T786C, C allele showed a weak association between C allele and DN risk in DN/T2DM group. For eNOS-G894T, there was an association between T allele and DN risk in the global, Asian and African population in DN/T2DM group. For the eNOS-4b/4a, 4a allele was found contributing significantly to increased DN risk in the global population.


CONCLUSIONS
Our comprehensive meta-analysis suggests that three polymorphisms of eNOS may be the increased risk factors of DN development, especially in Asian population and T2DM group.
a Department of Endocrinology , Zhongnan Hospital of Wuhan University , Wuhan , P.R. China .|b Department of Nephropathy , Taihe Hospital, Hubei University of Medicine , Shiyan , P.R. China , and.
Yong
Y
Zhang
b Department of Nephropathy , Taihe Hospital, Hubei University of Medicine , Shiyan , P.R. China , and.
Hou-Qin
HQ
Xiao
c Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine , Shiyan , P.R. China.
Xian-Tao
XT
Zeng
c Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine , Shiyan , P.R. China.
Hong-Xia
HX
Zuo
a Department of Endocrinology , Zhongnan Hospital of Wuhan University , Wuhan , P.R. China .
Yan-Cheng
YC
Xu
D044466:Asian People / Q000235:genetics; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors
D052250:Nitric Oxide Synthase Type III
Diabetes; diabetic nephropathy; endothelial nitric oxide synthase; meta-analysis; polymorphism