Association of tumor necrosis factor-α-308G/A polymorphism with the risk of obstructive sleep apnea: A meta-analysis of 14 case-control studies

Zhenlian Zhang; Dilihumaier Duolikun; Tingting Dang; Yuanyuan Wang; Lijuan Ma; Xueyun Ma; Qiaoling Yao

doi:10.1371/journal.pone.0290239

Association of tumor necrosis factor-α-308G/A polymorphism with the risk of obstructive sleep apnea: A meta-analysis of 14 case-control studies

PLoS One. 2023 Aug 18;18(8):e0290239. doi: 10.1371/journal.pone.0290239. eCollection 2023.

Authors

Zhenlian Zhang^{1

2}, Dilihumaier Duolikun¹, Tingting Dang³, Yuanyuan Wang³, Lijuan Ma^{1

2}, Xueyun Ma^{1

2}, Qiaoling Yao^{1

2}

Affiliations

¹ Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, China.
² Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Xinjiang Medical University, Urumqi, Xinjiang, China.
³ Third Clinical Medical College, Xinjiang Medical University, Urumqi, Xinjiang, China.

Abstract

Although numerous studies have suggested the association between TNF-α-308G/A polymorphism and susceptibility to obstructive sleep apnea (OSA), the results remained controversial and ambiguous. We performed the present meta-analysis to derive a more precise estimation.The PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang databases, and Weipu databases (until January 8, 2022) were accessed to retrieve relevant articles. Pooled odds ratios (ORs) with 95% confidence interval (95% CI) were calculated using the STATA statistical software.Totally, fourteen studies involving 2595 cases and 2579 controls were enrolled in this meta-analysis. Pooled results demonstrated significant association between TNF-α-308G/A polymorphism and OSA risk for the overall population(allele model:OR = 1.87 [1.47, 2.38] (n = 14), dominant model: OR = 1.88[1.48, 2.39] (n = 14), recessive model:OR = 2.83 [2.00, 4.00] (n = 11), homozygous model:OR = 3.30 [2.32, 4.68] (n = 11), and heterozygous model:OR = 1.67 [1.36, 2.06] (n = 14); P<0.001, respectively).Subgroup analysis showed that in both Caucasians and Asians, the A allele conferred increased risk to OSA compared to the G allele (Caucasians: OR = 1.40[1.03, 1.90] (n = 5), P = 0.033, Asians: OR = 2.30 [1.62, 3.26] (n = 9), P< 0.001). In subgroup analysis restricted to hospital-based individuals, significant association between TNF-α-308G/A polymorphism and OSA risk was identified under each genetic model. Whereas, in population-based individuals, increased risk of OSA were only found in homozygous model (OR = 2.19[1.23, 3.90] (n = 3), P = 0.008) and recessive model (OR = 1.77 [1.00, 3.13] (n = 3), P = 0.048). There was a substantial between-study heterogeneity (I2 = 69.10%) across studies which was explained by source of control participants (P = 0.036) by meta-regression. The results of leave-one-out meta-analysis and publication bias suggested the reliability and stability of our results.This meta-analysis suggested that TNF-α-308A allele may be a risk factor for the development of OSA. However, large scale,multi-center and well-designed case-control studies are needed in the future.

Copyright: © 2023 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Alleles
Case-Control Studies
Humans
Polymorphism, Genetic*
Reproducibility of Results
Tumor Necrosis Factor-alpha* / genetics

Substances

Tumor Necrosis Factor-alpha
TNF protein, human

Grants and funding

This study was supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region (No.2021D01C278) received by ZZL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.