Abstract
Background
Numbers of single nucleotide polymorphisms (SNPs) were identified as risk factors for obstructive sleep apnea syndrome (OSAS) in the Chinese population; however, published articles drew incompatible or even contradictory results.
Objective
The aim of this study was to investigate the susceptible SNPs and risk of OSAS in the Chinese population.
Methods
We conducted a meta-analysis of seven polymorphisms and risk of OSAS based on 21 case–control studies.
Results
The results of our study showed that tumor necrosis factor-α (TNF-α) −308 G/A (OR = 3.70, 95 % CI = 1.39–9.83), gene-linked polymorphic region (LPR) (OR = 0.57, 95 % CI = 0.41–0.79), and variable number tandem repeat (VNTR) of the 5-hydroxytryptamine transporter gene (5-HTT) (OR = 3.44, 95 % CI = 1.49–7.95) polymorphisms were associated with OSAS risk in the Chinese population, while there was no significant association between 5-hydroxytryptamine 2A receptor (5-HTR2A) 102C/T, 5-HTR2A A1438G, angiotensin-converting enzyme (ACE) insertion (I)/deletion (D), or leptin receptor (LEPR)-Gln 223Arg polymorphism and risk of OSAS in the Chinese population.
Conclusions
Our study demonstrated that TNF-α 308 G/A, 5-HTT LPR, and 5-HTT-VNTR polymorphisms were associated with OSAS risk, whereas little association was observed between 5-HTR2A 102C/T, 5-HTR2A A1438G, ACE I/D, or LEPR-Gln 223Arg polymorphism and risk of OSAS in the Chinese population.
Similar content being viewed by others
References
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235
Cao C, Ding Q, Lv D, Dong Z, Sun S, Chen Z, Shen H, Deng Z (2014) Vascular endothelial growth factor genotypes and haplotypes contribute to the susceptibility of obstructive sleep apnea syndrome. PLoS One 9:e114582
Ding Q, Cao C, Chen Z, Tabusi M, Chen L, Deng Z (2014) A functional EGF + 61 polymorphism is associated with severity of obstructive sleep apnea. Sleep Breath In press
Xiao Y, Huang X, Qiu C, Zhu X, Liu Y (1999) Angiotensin I converting enzyme gene polymorphism in Chinese patients with obstructive sleep apnea syndrome. Chin Med J 112:701–704
Zhang J, Zhao B, Gesongluobu SY, Wu Y, Pei W, Ye J, Hui R, Liu L (2000) Angiotensin-converting enzyme gene insertion/deletion (I/D) polymorphism in hypertensive patients with different degrees of obstructive sleep apnea. Hypertens Res 23:407–411
Ping F, Zhao JC, Zhang XQ, Gao FQ, Su L, Ding JY, Rong CL (2001) Association of the polymorphism of angiotensin converting enzyme with OSAS and OSAS accompanied by hypertension. Chin Gen Pract 4:24–26
Huang R, Huang XZ, Li M, Xiao Y, Zhang J (2003) An investigation of the relationship between Lepr gene Gln223Arg polymorphism and obstructive sleep apnea hypopnea syndrome. Zhonghua Jie He He Hu Xi Za Zhi 26:517–521
Zhang LQ, Yao WZ, He QY, Wang YZ, Ren B, Lin YP (2004) Association of polymorphisms in the angiotensin system genes with obstructive sleep apnea–hypopnea syndrome. Zhonghua Jie He He Hu Xi Za Zhi 27:507–510
Li S, Cao J, Chen BY (2004) Investigation of the angiotensin converting enzyme gene polymorphism in obstructive sleep apnea hypopnea syndrome. Chin J Respir Crit Care Med 3:350–353
Li Y, Zhang W, Wang T, Lu H, Wang X, Wang Y (2004) Study on the polymorphism of angiotensin converting enzyme genes and serum angiotensin II level in patients with obstructive sleep apnea hypopnea syndrome accompanied hypertension. Lin Chuang Er Bi Yan Hou Ke Za Zhi 18:456–459
Yue WH, Liu PZ, Hao W, Zhang XH, Wang XP, Zhang JS, Zhou XH, Xie YB, Ni M (2005) Association study of sleep apnea syndrome and polymorphisms in the serotonin transporter gene. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 22:533–536
Luo XJ (2006) The association between 5-hydroxytryptamine transporter gene, 5-hydroxytryptamine 2A receptor gene polymorphism and obstructive sleep apnea hypopnea syndrome. Dissertation, Wenzhou Medical University
Li WQ, Xie MZ, Li CQ, Liao WS, Ke XQ, Chen SW, Hu QS (2006) Investigation of the angiotensin-converting enzyme gene polymorphism in obstructive sleep apnea hypopnea syndrome patients with blood stasis syndrome. Chin J Trad Med Sci Tech 13:75–79
Gu XQ, Liu DB, Wan GP (2006) Polymorphism of angiotensin converting enzyme genes in children with obstructive sleep apnea syndrome. Zhonghua Er Ke Za Zhi 44:874–875
Liu HG, Guan P, Lin M, Xu YJ, Zhang ZX (2006) The relationship between tumor necrosis factor-alpha gene promoter polymorphism and obstructive sleep apnea-hypopnea syndrome. Zhonghua Jie He He Hu Xi Za Zhi 29:596–599
Zhu JY, Hu K, Ma ZS, Liu D (2007) The association between polymorphism of the serotonin 2A, 2C receptor genes and obstructive sleep apnea-hypopnea syndrome in Han population. Zhonghua Jie He He Hu Xi Za Zhi 30:912–917
Yue W, Liu H, Zhang J, Zhang X, Wang X, Liu T, Liu P, Hao W (2008) Association study of serotonin transporter gene polymorphisms with obstructive sleep apnea syndrome in Chinese Han population. Sleep 31:1535–1541
Tan Y (2010) The relation between leptin receptor gene Gln223Arg polymorphism and obstructive sleep apnea-hypopnea syndrome. Dissertation, Hebei Medical University
Han LH (2011) Relationship between serum leptin, polymorphism of leptin gene 2548G/A, leptin receptor gene Gln223Arg and correlation to obstructive sleep apnea hypopnea syndrome. Dissertation, Hebei United University
Tong H, Zhang M, Dong JY, Wang S, Ge H, Bai SL (2011) Association between the angiotensin converting enzyme gene polymorphism and intermittent hypoxia during sleep with high blood pressure. Chin J Histochem Cytochem 20:148–152
Yin G, Ye J, Han D, Zhang Y, Zeng W, Liang C (2012) A ssociation of the 5-HT2A receptor gene polymorphisms with obstructive sleep apnea hypopnea syndrome in Chinese Han population. Acta Otolaryngol 132:203–209
Chen H, Hu K, Zhu J, Xianyu Y, Cao X, Kang J, He J, Zhao P, Mei Y (2013) Polymorphisms of the 5-hydroxytryptamine 2A/2C receptor genes and 5-hydroxytryptamine transporter gene in Chinese patients with OSAHS. Sleep Breath 17:1241–1248
Guan Jian YH, Meng L, Su K, Yin S (2013) Study of association of TNF-alpha gene polymorphism with OSAHS and metabolic syndrome. Chin Arch Otolaryngol Head Neck Surg 20:8–12
Li T, Qian X, Guo R, Sun B, Liu C (2013) Relation between TNF-α polymorphism and obstructive sleep apnea syndrome accompanying hypertension. Acad J Chinese PLA Med Sch 34
Colditz GA, Burdick E, Mosteller F (1995) Heterogeneity in meta-analysis of data from epidemiologic studies: a commentary. Am J Epidemiol 142:371–382
Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta analysis detected by a simple, graphical test. BMJ 315:629–634
Ciftci TU, Kokturk O, Bukan N, Bilgihan A (2004) The relationship between serum cytokine levels with obesity and obstructive sleep apnea syndrome. Cytokine 28:87–91
Li NF, Yao XG, Zhu J, Yang J, Liu KJ, Wang YC, Wang XL, Zu FY (2010) Higher levels of plasma TNF-alpha and neuropeptide Y in hypertensive patients with obstructive sleep apnea syndrome. Clin Exp Hypertens 32:54–60
Zamarron C, Garcia Paz V, Riveiro A (2008) Obstructive sleep apnea syndrome is a systemic disease. Current evidence. Eur J Intern Med 19:390–398
Wilson AG, Symons JA, McDowell TL, McDevitt HO, Duff GW (1997) Effects of a polymorphism in the human tumor necrosis factor alpha promoter on transcriptional activation. Proc Natl Acad Sci U S A 94:3195–3199
Wilson AG, di Giovine FS, Blakemore AI, Duff G (1992) WSingle base polymorphism in the human tumour necrosis factor alpha (TNF alpha) gene detectable by NcoI restriction of PCR product. Hum Mol Genet 1:353
Zhong A, Xiong X, Xu H, Shi M (2014) An updated meta-analysis of the association between tumor necrosis factor-α -308G/a polymorphism and obstructive sleep apnea-hypopnea syndrome. PLoS One 9:e106270
Wu Y, Cao C, Wu Y, Zhang C, Zhu C, Ying S, Chen Z, Shen H, Li W (2014) TNF-α-308 G/a polymorphism contributes to obstructive sleep apnea syndrome risk: evidence based on 10 case–control studies. PLoS One 9:e106183
Douse MA, White DP (1996) Serotonergic effects on hypoglossal neural activity and reflex responses. Brain Res 726:213–222
Jelev A, Sood S, Liu H, Nolan P, Horner RL (2001) Microdialysis perfusion of 5-HT into hypoglossal motor nucleus differentially modulates genioglossus activity across natural sleep-wake states in rats. J Physiol 532:467–481
Zhan G, Shaheen F, Mackiewicz M, Fenik P, Veasey SC (2002) Single cell laser dissection with molecular beacon polymerase chain reaction identifies 2A as the predominant serotonin receptor subtype in hypoglossal motoneurons. Neuroscience 113:145–154
Esterling LE, Yoshikawa T, Turner G, Badner JA, Bengel D, Gershon ES, Berrettini WH, Detera-Wadleigh SD (1998) Serotonin transporter (5-HTT) gene and bipolar affective disorder. Am J Med Genet 81:37–40
Xu H, Guan J, Yi H, Yin S (2014) A systematic review and meta-analysis of the association between serotonergic gene polymorphisms and obstructive sleep apnea syndrome. PLoS One 9:e86460
Heils A, Teufel A, Petri S, Stober G, Riederer P, Bengel D, Lesch KP (1996) Allelic variation of human serotonin transporter gene expression. J Neurochem 66:2621–2624
Lesch KP, Bengel D, Heils A, Sabol SZ, Greenberg BD, Petri S, Benjamin J, Muller CR, Hamer DH, Murphy DL (1996) Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science 274:1527–1531
Greenberg BD, Tolliver TJ, Huang SJ, Li Q, Bengel D, Murohy DL (1999) Genetic variation in the serotonin transporter promoter region affects serotonin uptake in human blood platelets. Am J Med Genet 88:83–87
Veasey SC (2003) Serotonin agonists and antagonists in obstructive sleep apnea: therapeutic potential. Am J Respir Med 2:21–29
Masuda K, Hashizume C, Ogata N, Kikusui T, Takeuchi Y, Mori Y (2004) Sequencing of canine 5-hydroxytriptamine receptor (5-HTR) 1B, 2A, 2C genes and identification of polymorphisms in the 5-HTR1B gene. J Vet Med Sci 66:965–972
Zhao Y, Tao L, Nie P, Lu X, Xu X, Chen J, Zhu M (2013) Association between 5-HT2A receptor polymorphisms and risk of obstructive sleep apnea and hypopnea syndrome: a systematic review and meta-analysis. Gene 530:287–294
Wu Y, Liu HB, Ding M, Liu JN, Zhu XF, Gu JH, Lu G (2013) Association between the21438G/A and T102C polymorphisms of 5-HT2A receptor gene and obstructive sleep apnea: a meta-analysis. Mol Biol Rep 40:6223–6231
Zhou TB, Ou C, Qin YH, Su LN, Lei FY, Huang WF, Zhao YJ, Pang YS, Yang KP (2011) Association of angiotensin converting enzyme insertion/deletion gene polymorphism with idiopathic nephrotic syndrome susceptibility in children: a meta-analysis. J Renin Angiotensin Aldosterone Syst 12:601–610
Bernstein KE, Ong FS, Blackwell WL, Shah KH, Giani JF, Gonzalez-Villalobos RA, Shen XZ, Fuchs S, Touyz RM (2013) A modern understanding of the traditional and nontraditional biological functions of angiotensin-converting enzyme. Pharmacol Rev 65:1–46
Koyama RG, Drager LF, Lorenzi-Filho G, Cintra FD, Pereira AC, Poyares D, Krieger JE, Castro RM, Tufik S, de Mello MT, Pedrazzoli M (2009) Reciprocal interactions of obstructive sleep apnea and hypertension associated with ACE I/D polymorphism in males. Sleep Med 10:1107–1111
Feng Y, Ri J, Wan HY, Shi GC, Li QY, Fan L (2013) Meta-analysis demonstrates lack of association between the ACE gene I/D polymorphism and obstructive sleep apnea-hypopnea syndrome occurrence and severity. Genet Mol Res 12:74–84
Antunes H, Santos C, Carvalho S (2009) Serum leptin levels in overweight children and adolescents. Br J Nutr 101:1262–1266
Hroussalas G, Kassi E, Dalamaga M, Delimaris I, Zachari A, Dionyssiou-Asteriou A (2008) Leptin, soluble leptin receptor, adiponectin and resistin in relation to OGTT in overweight/obese postmenopausal women. Maturitas 59:339–349
Tokuda F, Sando Y, Matsui H, Koike H, Yokoyama T (2008) Serum levels of adipocytokines, adiponectin and leptin, in patients with obstructive sleep apnea syndrome. Intern Med 47:1843–1849
Acknowledgments
This work was partly supported by the grant of National Natural Science Foundation of China (NSFC) (No. 81000010, F Lan) and grant of Natural Science Foundation of Ningbo (No. 2012A610257, Z Deng) and Program of Medical Research of Ningbo (2013A19).
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lan, F., Cao, C., Liu, J. et al. Obstructive sleep apnea syndrome susceptible genes in the Chinese population: a meta-analysis of 21 case–control studies. Sleep Breath 19, 1441–1448 (2015). https://doi.org/10.1007/s11325-015-1176-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-015-1176-0