Single nucleotide polymorphisms and post-operative complications following major gastrointestinal surgery: A systematic review and meta-analysis

Beecham, Joseph, Hart, Andrew, Alexandre, Leo, Hernon, James, Kumar, Bhaskar ORCID: https://orcid.org/0000-0001-5705-1384 and Lam, Stephen ORCID: https://orcid.org/0000-0003-1040-938X (2019) Single nucleotide polymorphisms and post-operative complications following major gastrointestinal surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery, 23 (11). pp. 2298-2306. ISSN 1091-255X

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Abstract

Background: The human genome is an under-researched area of pre-operative risk stratification. Studies of genetic polymorphisms and their associations with acute post-operative complications in gastrointestinal surgery have reported statistically significant results, but have varied in methodology, genetic variations studied, and conclusions reached. To provide clarity, we conducted a systematic review and meta-analysis of single nucleotide polymorphisms and their association with post-operative complications after major gastro-8 intestinal surgery. Methods: We performed a literature search using Ovid MEDLINE and Web of Science databases. Studies were included if they investigated genetic polymorphisms and their associations with post-operative complications after major gastrointestinal surgery. We extracted clinical and genetic data from each paper and assessed for quality against the STrengthening the REporting of Genetic Association Studies (STREGA) guidelines. Odds ratios were presented, with 95% confidence intervals, to assess strengths of association. We conducted a meta-analysis on TNF-alpha-308, which had been assessed in three papers. Results: Our search returned 68 papers, of which 5 were included after screening and full-text review. Twenty-two different single nucleotide polymorphisms (SNPs) were investigated in these studies. We found that all papers were genetic association studies, and had selected SNPs related to inflammation. The outcome investigated was most commonly post-operative infection, but also anastomotic leak and other non-infectious complications. Statistically significant associations were found for: TNF-alpha-308, IL-10-819, PTGS2-765 and IFN-gamma-874. There was significant variability in study quality and methodology. We conducted a meta-analysis on associations between the TNF-alpha-308 polymorphism and post-operative infection and report an OR of 1.18 (CI 0.27 – 5.21). Conclusions: We found biologically plausible associations between SNPs involved in inflammation and post-operative infection, but the available data were too limited and of insufficient quality to reach definitive conclusions. Further work is needed, including genome-wide association studies (GWAS).

Item Type:	Article
Additional Information:	Early Title: The association between single nucleotide polymorphisms and post-operative complications following major gastrointestinal surgery: a systematic review and meta-analysis
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Depositing User:	LivePure Connector
Date Deposited:	04 Jun 2019 08:30
Last Modified:	20 Jun 2024 00:28
URI:	https://ueaeprints.uea.ac.uk/id/eprint/71245
DOI:	10.1007/s11605-019-04300-2

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