Association of rs2230806 in ABCA1 with coronary artery disease: An updated meta-analysis based on 43 research studies

BACKGROUND: As a key gene in the reverse transport pathway of cholesterol, ABCA1 (ATP-binding cassette transporter A1) plays an important role in the pathogenesis of coronary artery disease (CAD). In the ABCA1, rs2230806 is the most widely studied polymorphism and its role has been controversial. METHODS: We performed an updated meta-analysis by searching online electronic databases using the PubMed, Web of Science, Embase, Cochrane Library, EMBASE, Google Scholar, China National Knowledge Infrastructure, and Wan Fang databases before June 28, 2019. STATA12.0 software was used to perform a series of analyses on the data, including genetic effect model, heterogeneity, sensitivity, and publication bias analysis. RESULTS: Based on our inclusion and exclusion criteria, finally 43 articles including a total of 34,348 subjects (14,085 CAD cases and 20,263 healthy controls) were investigated. Results showed that carrying the K allele in rs223086 in the overall population significantly reduced the risk of CAD (OR = 0.745, 95% CI = 0.687–0.809, P < .001). After the ethnicity stratification analysis, the above phenomenon was found to be significant in Asian populations (OR = 0.686, 95% CI = 0.633–0.744, P < .001), marginally significant in Caucasians (OR = 0.887, 95% CI = 0.786–1.001, P = .051), and not significant in other populations (OR = 0.851, 95% CI = 0.558–1.297, P = .452). Further stratified according to the sample size in the Asian and Caucasian populations, in the Asian the K allele is more protective in small samples than large samples; however, in the Caucasian small samples carrying the K allele play a protective role while large samples are negative. In addition, according to the source of the control population and the geographical location in China, the results showed that rs2230806 was significantly associated with CAD in any group. Five genetic models (allelic, recessive, dominant, homozygote, and heterozygote) were analyzed in the above analysis. CONCLUSION: The K allele of rs2230806 was significantly associated with decreased risk of CAD, especially in Asian populations and small sample Caucasians.