Meta-analysis of 5-hydroxytryptamine transporter gene promoter region polymorphism and post-stroke depression

Objective: To investigate the relationship between 5-hydroxytryptamine transporter gene promoter region (5-HTTLPR) gene polymorphism and post-stroke depression (PSD).

Methods: We searched the CNKI, China Science and Technology Journal, China WanFang, PubMed, Embase, and Web of Science databases for studies of the relationship between 5-HTTLPR polymorphism and PSD. Data were evaluated using Stata software.

Results: The L allele was significantly related to the S allele (OR = 0.57, 95% confidence interval (CI) 0.49-0.65). The dominant genotype LL + LS was related to SS (OR = 0.48, 95%CI 0.39-0.59), the recessive genotype LL was related to LS + SS (OR = 0.39, 95%CI: 0.30-0.51), the homozygous genotype LL was related to SS (OR = 0.24, 95%CI 0.18-0.33), and the heterozygous genotype LS was related to SS (OR = 0.55, 95 CI 0.44-0.68). All the differences were significant. Ethnicity subgroup analysis showed significant differences among the five genotypes in both Asians and Caucasians. Hardy-Weinberg equilibrium (HWE) subgroup analysis showed that, after removal of a non-HWE-conforming control group, all five genotypes were significant and genotypes LL, LS + LL, and LS and L allele had beneficial effects on recovery from PSD.

Conclusion: 5-HTTLPR gene polymorphism is strongly associated with PSD, and the LL, LS + LL, and LS genotypes and L allele may protect against this condition.

Keywords: 5-hydroxytryptamine transporter gene promoter region; gene polymorphism; genetic model; genetic risk; meta-analysis; post-stroke depression.