Glutathione S-Transferase T1 (GSTT1) Null Polymorphism, Smoking, and Their Interaction in Coronary Heart Disease: A Comprehensive Meta-Analysis

Heart Lung Circ. 2017 Apr;26(4):362-370. doi: 10.1016/j.hlc.2016.07.005. Epub 2016 Aug 21.


Background: The association between glutathione S-transferase T1 (GSTT1) null polymorphism and coronary heart disease (CHD) is inconsistent among studies, and data on the GSTT1 null genotype-smoking interplay in CHD is lacking. We conducted this meta-analysis to investigate the relationship between GSTT1 null polymorphism and CHD and to assess the potential interaction between GSTT1 null genotype and smoking.

Methods: PubMed and EMBASE databases were searched up to 27 January 2016 using the appropriate terms. Odds ratios were pooled using either fixed-effects or random-effects models.

Results: Twenty-nine articles including 31 studies with 15,004 cases and 35,597 controls were eligible. The random-effects model showed that the GSTT1 null genotype was associated with increased CHD risk (OR=1.213, 95%CI: 1.004-1.467; I2=90.4%). After excluding 10 studies detected by Galbraith plot, the fixed effects summary estimate also showed an increased risk of CHD (OR=1.14, 95% CI: 1.06-1.22; I2=27.7%). A case-only analysis including eight studies showed a statistically significant positive interaction between GSTT1 null polymorphism and smoking status on CHD (OR=1.34, 95% CI: 1.09-1.64; I2=0%). Sensitivity analyses further supported the associations. No publication bias was observed.

Conclusions: This meta-analysis suggests that GSTT1 null polymorphism is associated with the risk of CHD. To our knowledge, this is the first meta-analysis to prove a positive effect of the interaction between GSTT1 null genotype and smoking status on the risk of CHD. Future studies with detailed individual information are needed to confirm our findings.

Keywords: Coronary heart disease; GSTT1; Genetic polymorphism; Meta-analysis; Smoking.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Coronary Disease / enzymology
  • Coronary Disease / genetics*
  • Female
  • Glutathione Transferase / genetics*
  • Humans
  • Male
  • Models, Genetic*
  • Polymorphism, Genetic*
  • Smoking / genetics*
  • Smoking / metabolism


  • glutathione S-transferase T1
  • Glutathione Transferase