Published online Dec 18, 2016. doi: 10.4254/wjh.v8.i35.1584
Peer-review started: June 28, 2016
First decision: August 10, 2016
Revised: September 9, 2016
Accepted: October 17, 2016
Article in press: October 18, 2016
Published online: December 18, 2016
To examine the association of PNPLA3 polymorphisms in chronic hepatitis C patients and development of liver disease spectrum.
Literature was searched systematically from PubMed/MEDLINE, EMBASE, and Cochrane search engines for full-length articles written in English that examined PNPLA3 polymorphism in chronic hepatitis C (CHC) patients. Studies evaluating the association of PNPLA3 polymorphism spectrum (fatty liver, steatohepatitis, cirrhosis, and hepatocellular carcinoma) of CHC were included. Pooled data are reported as OR with 95%CI. Our study endpoint was the risk of the entire liver disease spectrum including: Steatosis/fatty liver, cirrhosis, and hepatocellular carcinoma in CHC patients with PNPLA3 polymorphisms.
Of 380 studies identified, a total of 53 studies were included for full-text review. Nineteen on chronic hepatitis C were eligible for analysis. Pooled ORs for rs738409 GG compared to CC and CG among patients with fatty liver was 2.214 (95%CI: 1.719-2.853). ORs among advanced fibrosis/cirrhosis were 1.762 (95%CI: 1.258-2.468). Similar odds ratios among hepatocellular carcinoma patients were 2.002 (95%CI: 1.519-2.639). Pooled ORs for rs738409 GG and CG compared to CC among patients with fatty liver were 1.750 (95%CI: 1.542-1.986). Pooled ORs for advanced fibrosis/cirrhosis patients were 1.613 (95%CI: 1.211-2.147). All analyses were homogenous and without publication bias except one. The associations were maintained after adjusting for publication bias and heterogeneity.
PNPLA3 polymorphisms have strong association with increased risk and severity of the liver disease spectrum in CHC patients.
Core tip:PNPLA3 polymorphisms (rs738409 CG and GG) are associated with increased risk of steatosis, advanced fibrosis, cirrhosis, and hepatocellular carcinoma in chronic hepatitis C patients.