A systematic review and meta-analysis of the association between endothelial nitric oxide synthase (eNOS) rs2070744 polymorphism and preeclampsia

Objective: Preeclampsia, characterized by hypertension and proteinuria, is a medical condition associated with maternal and fetal morbidity and mortality. Previous studies reported conflicting correlations between the eNOS rs2070744 variant and the occurrence of preeclampsia. Due to inconsistencies in findings, the purpose of the present meta-analysis was to explore the precise link between the eNOS rs2070744 variant and the development of preeclampsia. Methods: The articles were retrieved from various online sources, including Cochrane Library, Google Scholar, EMBASE, PubMed, and Web of Science databases up to February 2024. Data were analyzed by Review Manager (RevMan) 5.4. We adhered to the PRISMA 2020 guidelines to conduct this meta-analysis. Results: A total of 26 articles containing 3741 cases and 4920 controls were included for qualitative and quantitative data synthesis. In the overall population, we found a strong correlation between the eNOS rs2070744 variant and higher preeclampsia risk in recessive (CC vs. CT + TT: OR = 1.31, p = 0.017) dominant (CC + CT vs. TT: OR = 1.14, p = 0.051), co-dominant 2 (CC vs. TT: OR = 1.37, p = 0.011) and allelic (C vs. T: OR = 1.14, p = 0.022) models. Our study also explored similar outcomes among the Caucasian population in dominant (CC + CT vs. TT: OR = 1.16, p = 0.048), recessive (CC vs. CT + TT: OR = 1.46, p = 0.027), allele (C vs. T: OR = 1.18, p = 0.044), co-dominant 2 (CC vs. TT: OR = 1.53, p = 0.027), and co-dominant 3 (CC vs. CT: OR = 1.46, p = 0.002) models. Besides, a significant risk of preeclampsia in the African population was observed in co-dominant 2 (CC vs. TT: OR = 2.11, p = 0.009), dominant (CC + CT vs. TT: OR = 1.58, p = 0.002) and allelic (C vs. T: OR = 1.45, p = 0.001) models. However, no association of this polymorphism with preeclampsia risk was reported in Asian and mixed populations. Conclusion: This study suggests a significant correlation between eNOS rs2070744 polymorphism and preeclampsia. However, more research on various ethnic groups is necessary to confirm the association.