Skip to main content
Top
Published in: BMC Ophthalmology 1/2013

Open Access 01-12-2013 | Research article

Two polymorphisms (rs699947, rs2010963) in the VEGFA gene and diabetic retinopathy: an updated meta-analysis

Authors: Yan Lu, Yirui Ge, Yuhua Shi, Jie Yin, Zhenping Huang

Published in: BMC Ophthalmology | Issue 1/2013

Login to get access

Abstract

Background

The vascular endothelial growth factor (VEGFA) gene has been suggested to play an important role in the pathogenesis of diabetic retinopathy (DR). However, the results have been inconsistent. In this study, we performed a meta-analysis to clarify the associations between VEGFA polymorphisms and DR risk.

Methods

Published literature from PubMed, EMBASE, Web of Science and Google Scholar were retrieved. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects model.

Results

A total of eight studies (1204 cases and 1198 controls) for rs699947 polymorphism and ten studies (1666 cases and 1782 controls) for rs2010963 polymorphism were included in the meta-analysis. The results suggested that rs699947 polymorphism was marginally associated with DR under a homogeneous co-dominant model (AA vs. CC: OR = 1.69, 95% CI = 1.03-2.77, p = 0.040) and a dominant model (AA + AC vs. CC: OR = 1.38, 95% CI = 1.01-1.90, p = 0.040), whereas the association between rs2010963 polymorphism and DR was not significant under all genetic models (all p > 0.05). In the subgroup analysis, the effect size for rs699947 polymorphism was only marginally significant among European populations under a dominant model (OR = 1.47, 95% CI = 1.07–2.02, p = 0.018), but not among East Asians. After exclusion of outliers which were the source of between-study heterogeneity, there was significant association between rs699947 polymorphism and DR under a homogeneous co-dominant model (OR = 1.64, 95% CI = 1.18-2.28, p = 0.003), even after multiple comparison correction.

Conclusions

Our meta-analysis confirmed the significant association between rs699947 polymorphism and DR after exclusion of outliers, and rs2010963 polymorphism might be not associated with DR.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fong DS, Aiello L, Gardner TW, King GL, Blankenship G, Cavallerano JD, et al: Retinopathy in diabetes. Diabetes Care. 2004, 271: S84-87.CrossRef Fong DS, Aiello L, Gardner TW, King GL, Blankenship G, Cavallerano JD, et al: Retinopathy in diabetes. Diabetes Care. 2004, 271: S84-87.CrossRef
3.
go back to reference Wirostko B, Wong TY, Simo R: Vascular endothelial growth factor and diabetic complications. Prog Retin Eye Res. 2008, 27: 608-621. 10.1016/j.preteyeres.2008.09.002.CrossRefPubMed Wirostko B, Wong TY, Simo R: Vascular endothelial growth factor and diabetic complications. Prog Retin Eye Res. 2008, 27: 608-621. 10.1016/j.preteyeres.2008.09.002.CrossRefPubMed
4.
go back to reference Qaum T, Xu Q, Joussen AM, Clemens MW, Qin W, Miyamoto K, et al: VEGF-initiated blood-retinal barrier breakdown in early diabetes. Invest Ophthalmol Vis Sci. 2001, 42: 2408-2413.PubMed Qaum T, Xu Q, Joussen AM, Clemens MW, Qin W, Miyamoto K, et al: VEGF-initiated blood-retinal barrier breakdown in early diabetes. Invest Ophthalmol Vis Sci. 2001, 42: 2408-2413.PubMed
5.
go back to reference Yang B, Cross DF, Ollerenshaw M, Millward BA, Demaine AG: Polymorphisms of the vascular endothelial growth factor and susceptibility to diabetic microvascular complications in patients with type 1 diabetes mellitus. J Diabetes Complications. 2003, 17: 1-6.CrossRefPubMed Yang B, Cross DF, Ollerenshaw M, Millward BA, Demaine AG: Polymorphisms of the vascular endothelial growth factor and susceptibility to diabetic microvascular complications in patients with type 1 diabetes mellitus. J Diabetes Complications. 2003, 17: 1-6.CrossRefPubMed
6.
go back to reference Awata T, Kurihara S, Takata N, Neda T, Iizuka H, Ohkubo T, et al: Functional VEGF C-634G polymorphism is associated with development of diabetic macular edema and correlated with macular retinal thickness in type 2 diabetes. Biochem Biophys Res Commun. 2005, 333: 679-685. 10.1016/j.bbrc.2005.05.167.CrossRefPubMed Awata T, Kurihara S, Takata N, Neda T, Iizuka H, Ohkubo T, et al: Functional VEGF C-634G polymorphism is associated with development of diabetic macular edema and correlated with macular retinal thickness in type 2 diabetes. Biochem Biophys Res Commun. 2005, 333: 679-685. 10.1016/j.bbrc.2005.05.167.CrossRefPubMed
7.
go back to reference Buraczynska M, Ksiazek P, Baranowicz-Gaszczyk I, Jozwiak L: Association of the VEGF gene polymorphism with diabetic retinopathy in type 2 diabetes patients. Nephrol Dial Transplant. 2007, 22: 827-832. 10.1093/ndt/gfl641.CrossRefPubMed Buraczynska M, Ksiazek P, Baranowicz-Gaszczyk I, Jozwiak L: Association of the VEGF gene polymorphism with diabetic retinopathy in type 2 diabetes patients. Nephrol Dial Transplant. 2007, 22: 827-832. 10.1093/ndt/gfl641.CrossRefPubMed
8.
go back to reference Abhary S, Burdon KP, Gupta A, Lake S, Selva D, Petrovsky N, et al: Common sequence variation in the VEGFA gene predicts risk of diabetic retinopathy. Invest Ophthalmol Vis Sci. 2009, 50: 5552-5558. 10.1167/iovs.09-3694.CrossRefPubMed Abhary S, Burdon KP, Gupta A, Lake S, Selva D, Petrovsky N, et al: Common sequence variation in the VEGFA gene predicts risk of diabetic retinopathy. Invest Ophthalmol Vis Sci. 2009, 50: 5552-5558. 10.1167/iovs.09-3694.CrossRefPubMed
9.
go back to reference Nakamura S, Iwasaki N, Funatsu H, Kitano S, Iwamoto Y: Impact of variants in the VEGF gene on progression of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2009, 247: 21-26. 10.1007/s00417-008-0915-3.CrossRefPubMed Nakamura S, Iwasaki N, Funatsu H, Kitano S, Iwamoto Y: Impact of variants in the VEGF gene on progression of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2009, 247: 21-26. 10.1007/s00417-008-0915-3.CrossRefPubMed
10.
go back to reference Chun MY, Hwang HS, Cho HY, Chun HJ, Woo JT, Lee KW, et al: Association of vascular endothelial growth factor polymorphisms with nonproliferative and proliferative diabetic retinopathy. J Clin Endocrinol Metab. 2010, 95: 3547-3551. 10.1210/jc.2009-2719.CrossRefPubMed Chun MY, Hwang HS, Cho HY, Chun HJ, Woo JT, Lee KW, et al: Association of vascular endothelial growth factor polymorphisms with nonproliferative and proliferative diabetic retinopathy. J Clin Endocrinol Metab. 2010, 95: 3547-3551. 10.1210/jc.2009-2719.CrossRefPubMed
11.
go back to reference Yang X, Deng Y, Gu H, Lim A, Altankhuyag A, Jia W, et al: Polymorphisms in the vascular endothelial growth factor gene and the risk of diabetic retinopathy in Chinese patients with type 2 diabetes. Mol Vis. 2011, 17: 3088-3096.PubMedPubMedCentral Yang X, Deng Y, Gu H, Lim A, Altankhuyag A, Jia W, et al: Polymorphisms in the vascular endothelial growth factor gene and the risk of diabetic retinopathy in Chinese patients with type 2 diabetes. Mol Vis. 2011, 17: 3088-3096.PubMedPubMedCentral
12.
go back to reference Errera FI, Canani LH, Silva ME, Yeh E, Takahashi W, Santos KG, et al: Functional vascular endothelial growth factor -634G > C SNP is associated with proliferative diabetic retinopathy: a case–control study in a Brazilian population of European ancestry. Diabetes Care. 2007, 30: 275-279. 10.2337/dc06-1399.CrossRefPubMed Errera FI, Canani LH, Silva ME, Yeh E, Takahashi W, Santos KG, et al: Functional vascular endothelial growth factor -634G > C SNP is associated with proliferative diabetic retinopathy: a case–control study in a Brazilian population of European ancestry. Diabetes Care. 2007, 30: 275-279. 10.2337/dc06-1399.CrossRefPubMed
13.
go back to reference Petrovic MG, Korosec P, Kosnik M, Osredkar J, Hawlina M, Peterlin B, et al: Local and genetic determinants of vascular endothelial growth factor expression in advanced proliferative diabetic retinopathy. Mol Vis. 2008, 14: 1382-1387.PubMedPubMedCentral Petrovic MG, Korosec P, Kosnik M, Osredkar J, Hawlina M, Peterlin B, et al: Local and genetic determinants of vascular endothelial growth factor expression in advanced proliferative diabetic retinopathy. Mol Vis. 2008, 14: 1382-1387.PubMedPubMedCentral
14.
go back to reference Uthra S, Raman R, Mukesh BN, Rajkumar SA, Padmaja KR, Paul PG, et al: Association of VEGF gene polymorphisms with diabetic retinopathy in a south Indian cohort. Ophthalmic Genet. 2008, 29: 11-15. 10.1080/13816810701663527.CrossRefPubMed Uthra S, Raman R, Mukesh BN, Rajkumar SA, Padmaja KR, Paul PG, et al: Association of VEGF gene polymorphisms with diabetic retinopathy in a south Indian cohort. Ophthalmic Genet. 2008, 29: 11-15. 10.1080/13816810701663527.CrossRefPubMed
15.
go back to reference Kangas-Kontio T, Vavuli S, Kakko SJ, Penna J, Savolainen ER, Savolainen MJ, et al: Polymorphism of the manganese superoxide dismutase gene but not of vascular endothelial growth factor gene is a risk factor for diabetic retinopathy. Br J Ophthalmol. 2009, 93: 1401-1406. 10.1136/bjo.2009.159012.CrossRefPubMed Kangas-Kontio T, Vavuli S, Kakko SJ, Penna J, Savolainen ER, Savolainen MJ, et al: Polymorphism of the manganese superoxide dismutase gene but not of vascular endothelial growth factor gene is a risk factor for diabetic retinopathy. Br J Ophthalmol. 2009, 93: 1401-1406. 10.1136/bjo.2009.159012.CrossRefPubMed
16.
go back to reference Feghhi M, Nikzamir A, Esteghamati A, Mahmoudi T, Yekaninejad MS: Relationship of vascular endothelial growth factor (VEGF) +405 G/C polymorphism and proliferative retinopathy in patients with type 2 diabetes. Transl Res. 2011, 158: 85-91. 10.1016/j.trsl.2011.03.002.CrossRefPubMed Feghhi M, Nikzamir A, Esteghamati A, Mahmoudi T, Yekaninejad MS: Relationship of vascular endothelial growth factor (VEGF) +405 G/C polymorphism and proliferative retinopathy in patients with type 2 diabetes. Transl Res. 2011, 158: 85-91. 10.1016/j.trsl.2011.03.002.CrossRefPubMed
17.
go back to reference Abhary S, Hewitt AW, Burdon KP, Craig JE: A systematic meta-analysis of genetic association studies for diabetic retinopathy. Diabetes. 2009, 58: 2137-2147. 10.2337/db09-0059.CrossRefPubMedPubMedCentral Abhary S, Hewitt AW, Burdon KP, Craig JE: A systematic meta-analysis of genetic association studies for diabetic retinopathy. Diabetes. 2009, 58: 2137-2147. 10.2337/db09-0059.CrossRefPubMedPubMedCentral
18.
go back to reference Zhao T, Zhao J: Association between the -634C/G polymorphisms of the vascular endothelial growth factor and retinopathy in type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract. 2010, 90: 45-53. 10.1016/j.diabres.2010.05.029.CrossRefPubMed Zhao T, Zhao J: Association between the -634C/G polymorphisms of the vascular endothelial growth factor and retinopathy in type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract. 2010, 90: 45-53. 10.1016/j.diabres.2010.05.029.CrossRefPubMed
19.
go back to reference Qiu M, Xiong W, Liao H, Li F: VEGF -634G > C polymorphism and diabetic retinopathy risk: a meta-analysis. Gene. 2013, 518: 310-315. 10.1016/j.gene.2013.01.018.CrossRefPubMed Qiu M, Xiong W, Liao H, Li F: VEGF -634G > C polymorphism and diabetic retinopathy risk: a meta-analysis. Gene. 2013, 518: 310-315. 10.1016/j.gene.2013.01.018.CrossRefPubMed
20.
go back to reference Yang Y, Andresen BT, Yang K, Zhang Y, Li X, Li X, et al: Association of vascular endothelial growth factor -634C/G polymorphism and diabetic retinopathy in type 2 diabetic Han Chinese. Exp Biol Med (Maywood). 2010, 235: 1204-1211. 10.1258/ebm.2010.010102.CrossRef Yang Y, Andresen BT, Yang K, Zhang Y, Li X, Li X, et al: Association of vascular endothelial growth factor -634C/G polymorphism and diabetic retinopathy in type 2 diabetic Han Chinese. Exp Biol Med (Maywood). 2010, 235: 1204-1211. 10.1258/ebm.2010.010102.CrossRef
21.
go back to reference DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials. 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2.CrossRefPubMed DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials. 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2.CrossRefPubMed
22.
go back to reference Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959, 22: 719-748.PubMed Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959, 22: 719-748.PubMed
23.
go back to reference Begg CB, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994, 50: 1088-1101. 10.2307/2533446.CrossRefPubMed Begg CB, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994, 50: 1088-1101. 10.2307/2533446.CrossRefPubMed
24.
go back to reference Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997, 315: 629-634. 10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997, 315: 629-634. 10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral
25.
go back to reference Arden GB, Sivaprasad S: The pathogenesis of early retinal changes of diabetic retinopathy. Doc Ophthalmol. 2012, 124: 15-26. 10.1007/s10633-011-9305-y.CrossRefPubMed Arden GB, Sivaprasad S: The pathogenesis of early retinal changes of diabetic retinopathy. Doc Ophthalmol. 2012, 124: 15-26. 10.1007/s10633-011-9305-y.CrossRefPubMed
26.
go back to reference Kim HW, Ko GJ, Kang YS, Lee MH, Song HK, Kim HK, et al: Role of the VEGF 936 C/T polymorphism in diabetic microvascular complications in type 2 diabetic patients. Nephrology (Carlton). 2009, 14: 681-688. 10.1111/j.1440-1797.2009.01085.x.CrossRef Kim HW, Ko GJ, Kang YS, Lee MH, Song HK, Kim HK, et al: Role of the VEGF 936 C/T polymorphism in diabetic microvascular complications in type 2 diabetic patients. Nephrology (Carlton). 2009, 14: 681-688. 10.1111/j.1440-1797.2009.01085.x.CrossRef
27.
go back to reference Paine SK, Basu A, Mondal LK, Sen A, Choudhuri S, Chowdhury IH, et al: Association of vascular endothelial growth factor, transforming growth factor beta, and interferon gamma gene polymorphisms with proliferative diabetic retinopathy in patients with type 2 diabetes. Mol Vis. 2012, 18: 2749-2757.PubMedPubMedCentral Paine SK, Basu A, Mondal LK, Sen A, Choudhuri S, Chowdhury IH, et al: Association of vascular endothelial growth factor, transforming growth factor beta, and interferon gamma gene polymorphisms with proliferative diabetic retinopathy in patients with type 2 diabetes. Mol Vis. 2012, 18: 2749-2757.PubMedPubMedCentral
28.
go back to reference Bonnefond A, Saulnier PJ, Stathopoulou MG, Grarup N, Ndiaye NC, Roussel R, et al: What is the contribution of two genetic variants regulating VEGF levels to type 2 diabetes risk and to microvascular complications?. PLoS One. 2013, 8: e55921-10.1371/journal.pone.0055921.CrossRefPubMedPubMedCentral Bonnefond A, Saulnier PJ, Stathopoulou MG, Grarup N, Ndiaye NC, Roussel R, et al: What is the contribution of two genetic variants regulating VEGF levels to type 2 diabetes risk and to microvascular complications?. PLoS One. 2013, 8: e55921-10.1371/journal.pone.0055921.CrossRefPubMedPubMedCentral
29.
go back to reference Awata T, Inoue K, Kurihara S, Ohkubo T, Watanabe M, Inukai K, et al: A common polymorphism in the 5′-untranslated region of the VEGF gene is associated with diabetic retinopathy in type 2 diabetes. Diabetes. 2002, 51: 1635-1639. 10.2337/diabetes.51.5.1635.CrossRefPubMed Awata T, Inoue K, Kurihara S, Ohkubo T, Watanabe M, Inukai K, et al: A common polymorphism in the 5′-untranslated region of the VEGF gene is associated with diabetic retinopathy in type 2 diabetes. Diabetes. 2002, 51: 1635-1639. 10.2337/diabetes.51.5.1635.CrossRefPubMed
30.
go back to reference Nakanishi K, Watanabe C: Single nucleotide polymorphisms of vascular endothelial growth factor gene intron 2 are markers for early progression of diabetic retinopathy in Japanese with type 1 diabetes. Clin Chim Acta. 2009, 402: 171-175. 10.1016/j.cca.2009.01.004.CrossRefPubMed Nakanishi K, Watanabe C: Single nucleotide polymorphisms of vascular endothelial growth factor gene intron 2 are markers for early progression of diabetic retinopathy in Japanese with type 1 diabetes. Clin Chim Acta. 2009, 402: 171-175. 10.1016/j.cca.2009.01.004.CrossRefPubMed
31.
go back to reference Churchill AJ, Carter JG, Ramsden C, Turner SJ, Yeung A, Brenchley PE, et al: VEGF polymorphisms are associated with severity of diabetic retinopathy. Invest Ophthalmol Vis Sci. 2008, 49: 3611-3616. 10.1167/iovs.07-1383.CrossRefPubMed Churchill AJ, Carter JG, Ramsden C, Turner SJ, Yeung A, Brenchley PE, et al: VEGF polymorphisms are associated with severity of diabetic retinopathy. Invest Ophthalmol Vis Sci. 2008, 49: 3611-3616. 10.1167/iovs.07-1383.CrossRefPubMed
32.
go back to reference Al-Kateb H, Mirea L, Xie X, Sun L, Liu M, Chen H, et al: Multiple variants in vascular endothelial growth factor (VEGFA) are risk factors for time to severe retinopathy in type 1 diabetes: the DCCT/EDIC genetics study. Diabetes. 2007, 56: 2161-2168. 10.2337/db07-0376.CrossRefPubMed Al-Kateb H, Mirea L, Xie X, Sun L, Liu M, Chen H, et al: Multiple variants in vascular endothelial growth factor (VEGFA) are risk factors for time to severe retinopathy in type 1 diabetes: the DCCT/EDIC genetics study. Diabetes. 2007, 56: 2161-2168. 10.2337/db07-0376.CrossRefPubMed
33.
go back to reference Ray D, Mishra M, Ralph S, Read I, Davies R, Brenchley P: Association of the VEGF gene with proliferative diabetic retinopathy but not proteinuria in diabetes. Diabetes. 2004, 53: 861-864. 10.2337/diabetes.53.3.861.CrossRefPubMed Ray D, Mishra M, Ralph S, Read I, Davies R, Brenchley P: Association of the VEGF gene with proliferative diabetic retinopathy but not proteinuria in diabetes. Diabetes. 2004, 53: 861-864. 10.2337/diabetes.53.3.861.CrossRefPubMed
34.
go back to reference Suganthalakshmi B, Anand R, Kim R, Mahalakshmi R, Karthikprakash S, Namperumalsamy P, et al: Association of VEGF and eNOS gene polymorphisms in type 2 diabetic retinopathy. Mol Vis. 2006, 12: 336-341.PubMed Suganthalakshmi B, Anand R, Kim R, Mahalakshmi R, Karthikprakash S, Namperumalsamy P, et al: Association of VEGF and eNOS gene polymorphisms in type 2 diabetic retinopathy. Mol Vis. 2006, 12: 336-341.PubMed
35.
go back to reference Szaflik JP, Wysocki T, Kowalski M, Majsterek I, Borucka AI, Blasiak J, et al: An association between vascular endothelial growth factor gene promoter polymorphisms and diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2008, 246: 39-43.CrossRefPubMed Szaflik JP, Wysocki T, Kowalski M, Majsterek I, Borucka AI, Blasiak J, et al: An association between vascular endothelial growth factor gene promoter polymorphisms and diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2008, 246: 39-43.CrossRefPubMed
36.
go back to reference Katsura Y, Okano T, Matsuno K, Osako M, Kure M, Watanabe T, et al: Erythropoietin is highly elevated in vitreous fluid of patients with proliferative diabetic retinopathy. Diabetes Care. 2005, 28: 2252-2254. 10.2337/diacare.28.9.2252.CrossRefPubMed Katsura Y, Okano T, Matsuno K, Osako M, Kure M, Watanabe T, et al: Erythropoietin is highly elevated in vitreous fluid of patients with proliferative diabetic retinopathy. Diabetes Care. 2005, 28: 2252-2254. 10.2337/diacare.28.9.2252.CrossRefPubMed
Metadata
Title
Two polymorphisms (rs699947, rs2010963) in the VEGFA gene and diabetic retinopathy: an updated meta-analysis
Authors
Yan Lu
Yirui Ge
Yuhua Shi
Jie Yin
Zhenping Huang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2013
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-13-56

Other articles of this Issue 1/2013

BMC Ophthalmology 1/2013 Go to the issue