Association of G308A and G238A Polymorphisms of the TNF-α Gene with Risk of Coronary Heart Disease: Systematic Review and Meta-analysis

Background and Aims. It is widely acknowledged that coronary heart disease (CHD) has a genetic influence. One of the most promising candidate genes is tumor necrosis factor alpha (TNF-alpha). Although there have been several positive studies associating the TNF-alpha gene and CHD, the evidence is not entirely consistent. The aim of the study was to evaluate the role of the TNF-alpha gene in CHD using combined evidence by generating a meta analysis and a systematic review of all published data. Methods. Meta-analysis and systematic review were conducted using 27 articles of genetic association studies of the TNF-alpha gene variants (G308A and G238A) and CHD. To analyze the association we used allelic, additive, dominant and recessive models. Moreover, we conducted a subanalysis by populations using the same four models. Results. TNF-alpha variant G308A showed a significant association with CHD but only when the analysis comprised the whole population. In addition, the variant G238A yielded the same outcome in the Asian population. Conclusions. Genetic polymorphisms at positions -308 and -238 in the promoter region of the TNF-alpha gene may be useful as predictive factors for CHD. (C) 2016 IMSS. Published by Elsevier Inc.