OPRM1基因A118G多态性与吗啡使用剂量的meta分析

Association Between A118G Polymorphism in OPRM1 Gene on Morphine Dosage: A Meta-analysis

关键词:  OPRM1基因A118G多态性  吗啡  使用剂量  meta分析

Key words:  OPRM1 gene A118G polymorphism  morphine  dosage  meta-analysis

摘要:

目的 系统评价OPRM1基因A118G多态性与吗啡使用剂量之间的相关性。方法 检索PubMed和EMBASE数据库以评估OPRM1基因A118G多态性与吗啡使用剂量相关性的病例-对照研究。采用Stata 12.0软件进行系统性评价。结果 共纳入16篇文献，合计患者4 115例。Meta分析结果显示：OPRM1基因A118G多态性突变野生杂合子（AG）吗啡的需要量比野生纯合子（AA）高（P=0.009），突变纯合子（GG）吗啡的需要量较纯合子（AA）更高（P=0.000）。显性遗传模型（AG+GG）吗啡的需要量较野生纯合子（AA）高（P=0.000）。亚组分析中，对于种族，突变纯合子（GG）、野生杂合子（AG）和野生纯合子（AA），白种人群吗啡需求量均高于亚洲人群，且患者年龄和疼痛评分也是吗啡需求量的重要预测因子。结论 在OPRM1基因A118G多态性突变中，G等位基因携带者均需要较高剂量的吗啡，且白种人群吗啡需求量均高于亚洲人群。

Abstract:

OBJECTIVE To systematically evaluate the association between OPRM1 gene A118G polymorphism and morphine dosage. METHODS Case-control study that retrieved PubMed and EMBASE databases to assess the correlation between OPRM1 gene A118G polymorphism and morphine dosage. Meta-analysis was performed by using Stata 12.0 software. RESULTS A total of 16 case-control studies involving 4 115 patients were included. The results of meta-analysis showed that the morphine requirement of wild heterozygotes(AG) of OPRM1 gene A118G polymorphism was higher than that of wild homozygotes(AA)(P=0.009), and the morphine requirement of mutant homozygotes(GG) was higher than that of homozygotes(AA)(P=0.000). The morphine requirement of dominant genetic model(AG+GG) was higher than that of wild homozygote(AA)(P=0.000). In the subgroup analysis, for race, the mutant homozygotes(GG), wild heterozygotes(AG) and wild homozygotes(AA), the requirement for morphine in the Caucasian population was higher than in the Asian population, and patient age and pain scores were also significant predictors of morphine consumption. CONCLUSION In the A118G polymorphism mutation of OPRM1 gene, G allele carriers have a higher demand for morphine, and the requirement for morphine in the Caucasian population was higher than in the Asian population.