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Journal of Diabetes & Metabolic Disorders
Published in: Journal of Diabetes & Metabolic Disorders 2/2020

01-12-2020 | Diabetic Retinopathy | Review article

Association of plasminogen activator inhibitor-1 4G5G Polymorphism with risk of diabetic nephropathy and retinopathy: a systematic review and meta-analysis

Authors: Seyed Alireza Dastgheib, Farzaneh Najafi, Ahmad Shajari, Reza Bahrami, Fatemeh Asadian, Jalal Sadeghizadeh-Yazdi, Elahe Akbarian, Seyed Alireza Emarati, Hossein Neamatzadeh

Published in: Journal of Diabetes & Metabolic Disorders | Issue 2/2020

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Abstract

Background

The 4G5G polymorphism of Plasminogen activator inhibitor-1 (PAI-1) gene is reported to be associated with diabetes nephropathy and retinopathy (DNR) risk. However, the findings are conflicting. Herein, we conducted a case-control and meta-analysis study to explore the association of PAI-1 4G5G polymorphism with risk of DNR.

Methods

We retrieved PubMed, EMBASE, Web of Knowledge, and CNKI databases and screened eligible studies up to August 15, 2020. The strength of associations was assessed by odd ratio (OR) and the corresponding 95% confidence interval (95% CI).

Results

A total of 27 case-control studies including 16 studies with 1,825 cases case and 1,731 controls on DN and eleven studies with 1,397 cases and 1,545 controls on DR were selected. Pooled data showed that the PAI-1 4G5G polymorphism was significantly associated with DN (allele model: OR = 0.674, 95% CI 0.524–0.865, p = 0.002; homozygote model: OR = 0.536, 95% CI 0.351–0.817, p = 0.004; heterozygote model: OR = 0.621, 95% CI 0.427–0.903, p = 0.013; dominant model: OR = 0.575, 95% CI 0.399–0.831, p = 0.003; and recessive model: OR = 0.711, 95% CI 0.515–0.981, p = 0.038) and DR (homozygote model: OR = 0.770, 95% CI 0.621–0.955, p = 0.0.017) risk. Stratified analyses by ethnicity indicated that PAI-1 4G5G polymorphism was associated with DN and DR risk in Asians and Caucasians, respectively.

Conclusions

The present meta-analysis revealed that the PAI-1 4G5G polymorphism was associated with increased risk of DN and DR risk. However, well-designed large-scale clinical studies are required to further validate our results.
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Metadata
Title
Association of plasminogen activator inhibitor-1 4G5G Polymorphism with risk of diabetic nephropathy and retinopathy: a systematic review and meta-analysis
Authors
Seyed Alireza Dastgheib
Farzaneh Najafi
Ahmad Shajari
Reza Bahrami
Fatemeh Asadian
Jalal Sadeghizadeh-Yazdi
Elahe Akbarian
Seyed Alireza Emarati
Hossein Neamatzadeh
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Journal of Diabetes & Metabolic Disorders / Issue 2/2020
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-020-00675-1

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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