• Lian Gu, Guangliang Wu, Jianxiong Long, Li Su, Yan Yan, Qing Chen, Juanjuan Xie, and Yanling Hu.
• Department of Internal Neurology, Guangxi Traditional Chinese Medicine University, Nanning, China.
• Am. J. Med. Sci. 2013 Mar 1; 345 (3): 227233227-33.

BackgroundStroke is a common health problem; however, its pathogenesis is not clear. Several studies have examined the association of -308G>A promoter polymorphism in the tumor necrosis factor-α gene (TNF-α) with ischemic stroke susceptibility. However, the results of these studies are inconsistent and the sample sizes of most of the studies were small. Thus, a meta-analysis was conducted to provide a more robust estimate of the effect of the TNF-α 308G>A polymorphism on the risk for ischemic stroke.MethodsOdds ratios with 95% confidence intervals were used to assess the strength of the association of TNF-α polymorphisms with ischemic stroke. Cochran's Q statistic and the inconsistency index (I) were used to explore heterogeneity. Egger's test and inverted funnel plots were used to investigate publication bias.ResultsThirteen studies met the inclusion criteria involving 3515 cases and 3949 controls. A significant association was found between TNF-α 308G>A polymorphism and the development of ischemic stroke in the Asian population. However, no statistically significant association was observed in the overall analysis and in the Caucasian population. In the subgroup analysis by age, a significant association was found in the juvenile and adult populations, showing that TNF-α 308G>A polymorphism is associated with the risk for juvenile ischemic stroke.ConclusionsThis study suggests that TNF-α 308G>A polymorphism is associated with the risk for juvenile ischemic stroke, whereas it is a protective factor for ischemic stroke in Asians and the adult population. However, in the overall analysis and in Caucasians, a significant association was not found.

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