Matrix metalloproteinase 9 (MMP9) level and MMP9 -1562C>T in patients with obstructive sleep apnea: a systematic review and meta-analysis of case-control studies

Xiaolian Fang; Jun Chen; Wei Wang; Guoshuang Feng; Xiaodan Li; Xin Zhang; Yamei Zhang; Jie Zhang; Zhifei Xu; Jun Tai; Xin Ni

doi:10.1016/j.sleep.2019.11.1247

Matrix metalloproteinase 9 (MMP9) level and MMP9 -1562C>T in patients with obstructive sleep apnea: a systematic review and meta-analysis of case-control studies

Sleep Med. 2020 Mar:67:110-119. doi: 10.1016/j.sleep.2019.11.1247. Epub 2019 Dec 4.

Authors

Xiaolian Fang¹, Jun Chen², Wei Wang², Guoshuang Feng², Xiaodan Li¹, Xin Zhang², Yamei Zhang¹, Jie Zhang¹, Zhifei Xu³, Jun Tai⁴, Xin Ni⁵

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, National Children's Medical Center/Beijing Children's Hospital, Capital Medical University, Beijing, PR China.
² Big Data and Engineering Research Center, National Children's Medical Center/Beijing Children's Hospital, Capital Medical University, Beijing, PR China.
³ Respiratory Department, National Children's Medical Center/Beijing Children's Hospital, Capital Medical University, Beijing, PR China.
⁴ Department of Otolaryngology, Head and Neck Surgery, National Children's Medical Center/Beijing Children's Hospital, Capital Medical University, Beijing, PR China. Electronic address: trenttj@163.com.
⁵ Department of Otolaryngology, Head and Neck Surgery, National Children's Medical Center/Beijing Children's Hospital, Capital Medical University, Beijing, PR China. Electronic address: nixin@bch.com.cn.

PMID: 31918116
DOI: 10.1016/j.sleep.2019.11.1247

Abstract

Background: The peripheral level of matrix metalloproteinase (MMP)-9 and polymorphism of MMP9 -1562C>T in patients with obstructive sleep apnea (OSA) remains controversial. Therefore, the aims of this systemic review and meta-analysis are to assess the MMP9 level in OSA patients and identify the relationship between MMP9 -1562C>T and OSA susceptibility.

Methods: This systematic review was performed following the PRISMA guideline. We searched for studies in major databases, identifying those indexed from inception to July 3, 2019 which related to MMP9 level, MMP9 -1562C>T and OSA. The pooled standardized mean differences (SMDs) and 95% confidence interval (CI) of MMP9 levels were calculated. In addition, the relationship between MMP9 -1562C>T and OSA susceptibility was assessed by three genetic models. The heterogeneity analysis and calculation of the pooled odds ratio (OR) were also performed, followed by quality assessment using the Newcastle-Ottawa Scale (NOS).

Results: In sum, our review included 15 eligible studies regarding MMP9 level and three regarding MMP9 -1562C>T. The pooled results showed that peripheral level of MMP9 was increased in OSA patients (SMD = 1.37; 95% CI = 1.15-1.59). Furthermore, significant difference of MMP9 level can be found between severe and mild-to-moderate OSA patients (SMD = 28.17; 95% CI = 4.23-52.11) or between moderate-severe and mild OSA (SMD = 36.62; 95% CI = 12.19-61.04). However, no relationship was observed between MMP9 -1562C>T and OSA susceptibility in three genetic models (Homozygote model, OR = 1.37; 95% CI = 0.87-2.18); (Recessive model, OR = 1.42; 95% CI = 0.83-2.42); (Allele model, OR = 1.07; 95% CI = 0.96-1.18).

Conclusions: This systemic review and meta-analysis indicated that the level of MMP9 was increased in patients with OSA and this increase is relevant to OSA severity. Moreover, the relationship between MMP9 -1562 C>T and OSA susceptibility has currently not been proven by current merging values. Further analyses with larger sample size are required to verify these associations.

Keywords: Matrix metalloproteinase (MMP)-9; Meta-analysis; Obstructive sleep apnea (OSA); Polymorphism.

Publication types

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

MeSH terms

Alleles
Case-Control Studies
Humans
Matrix Metalloproteinase 9* / blood
Matrix Metalloproteinase 9* / genetics
Polymorphism, Genetic*
Sleep Apnea, Obstructive* / blood
Sleep Apnea, Obstructive* / genetics

Substances

Matrix Metalloproteinase 9
MMP9 protein, human