Association between the serotonin transporter linked polymorphic region and lifelong premature ejaculation: An updated meta-analysis of case–control studies

Previous studies on the association between serotonin transporter linked polymorphic region (5-HTTLPR) polymorphism and premature ejaculation (PE) have led to inconsistent results. The purpose of the present meta-analysis was to examine whether 5-HTTLPR polymorphism is associated with PE susceptibility. All eligible studies were searched and acquired from PubMed, Embase, Science Direct, CNKI, and Wanfang databases according to inclusion and exclusion criteria. Odds ratios (ORs) with 95% confidence intervals (CIs) were computed to assess the strength of the association between 5-HTTLPR polymorphism and PE. In addition, heterogeneity test, publication bias and sensitivity analysis were also conducted. Firstly, the association were observed in 8 studies (L vs S: OR = 0.74, 95% CI = 0.63–0.87; LL vs SS: OR = 0.61, 95% CI = 0.44–0.83; SL vs SS: OR = 0.73, 95% CI = 0.55–0.96; LL + SL vs SS: OR = 0.67, 95% CI = 0.52–0.86; LL vs SL + SS: OR = 0.72, 95% CI = 0.55–0.92). When the 2 studies not in Hardy–Weinberg equilibrium (HWE) were omitted, a positive association could only be observed between the 5-HTTLPR polymorphism and PE in allele contrast model (L vs S: OR = 0.81, 95% CI = 0.67–0.98). In the stratified analysis by subgroup, significantly associations were also found between PE and 5-HTTLPR polymorphism in Caucasians but not Asians (L vs S: OR = 0.79, 95% CI = 0.63–0.98; LL + SL vs SS: OR = 0.67, 95% CI = 0.46–0.96). Our meta-analysis demonstrated that the 5-HTTLPR polymorphism was associated with the susceptibility to PE in the Caucasian population. Compared with S allele, L allele is likely to be less susceptible to PE.