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Toxics 2018, 6(3), 44;

Meta-Analysis of NOS3 G894T Polymorphisms with Air Pollution on the Risk of Ischemic Heart Disease Worldwide

College of Nursing, Augusta University, 987 St. Sebastian Way, EC 4505, Augusta, GA 30912, USA
Department of Nursing, Yuanpei University of Medical Technology No. 306, Yuanpei Street, 30015 Hsinchu, Taiwan
Department of Nursing, National University, San Diego, CA 92127, USA
School of Nursing, National Taiwan University, Taipei 10051, Taiwan
Department of Psychology, Azusa Pacific University, Azusa, CA 91702, USA
Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
Author to whom correspondence should be addressed.
Received: 1 June 2018 / Revised: 22 July 2018 / Accepted: 27 July 2018 / Published: 1 August 2018
(This article belongs to the Special Issue Particulate matter exposure and health effects)
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The purpose of this updated meta-analysis was to investigate the effect of nitric oxide synthase-3 (NOS3) G894T polymorphisms, air pollution and their interaction on ischemic heart disease (IHD) risk across populations worldwide. Recursive partition trees, nonlinear association curve fit and geographic information system maps were incorporated to verify results of conventional pooled analyses for sources of heterogeneity. Results from 61 studies (16,219 cases, 12,222 controls) revealed a significant increased relative risk (RR) of IHD associated with NOS3 894 polymorphisms TT (RR = 1.44) and GT (RR = 1.37). Subgroup analysis revealed that the TT polymorphism genotype had significantly increased risk of IHD in Caucasian, East Asian, South Asian, and Middle Eastern populations (all p < 0.05). It is important to point out that many countries demonstrated an average risk of greater than two, which identifies the NOS3 894 TT polymorphism as a potential causal factor and biological marker of IHD, based on criteria for strong evidence used in international consensus panels. These 10 countries include Ukraine, the United Kingdom, Brazil, Chile, Japan, South Korea, India, Iran, Egypt and Morocco. For these countries with elevated risk (RR > 2) from the NOS3 894 TT polymorphism, meta-predictive analysis demonstrated an increasing trend in air pollution association with increased NOS3 894 polymorphisms. Further studies are needed to explore the complexity of the associations among NOS3 gene polymorphisms per population stratifications within countries, detailed air pollution data for added specificity for geographic location across time, and disease risk. View Full-Text
Keywords: meta-analysis; NOS3 G894T gene; ischemic heart disease; cardiovascular disease meta-analysis; NOS3 G894T gene; ischemic heart disease; cardiovascular disease

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Johns, R.; Chen, Z.-F.; Young, L.; Delacruz, F.; Chang, N.-T.; Yu, C.H.; Shiao, S.P.K. Meta-Analysis of NOS3 G894T Polymorphisms with Air Pollution on the Risk of Ischemic Heart Disease Worldwide. Toxics 2018, 6, 44.

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