Neuropsychopharmacology. 2013 Aug;38(9):1737-47. doi: 10.1038/npp.2013.73. Epub  2013 Mar 21.
Multi-cultural association of the serotonin transporter gene (SLC6A4) with substance use disorder.
Cao J1, Hudziak JJ, Li D.
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Abstract
A
 number of studies have reported associations between the serotonin 
transporter gene (SLC6A4) and alcohol, heroin, cocaine, or 
methamphetamine abuse. Other studies have yielded contrary results. 
There are a number of reasons for non-replication, including inadequate 
statistical power, population stratification, and poor phenotype 
definition. This study was to test the association using a meta-analytic
 approach across a variety of racial and ethnic populations. Using the 
genotype data of 55 studies (7999 cases, 8264 controls, and 676 families
 or parent-offspring trios) published in the past 15 years, we have 
conducted comprehensive meta-analyses to examine the associations of the
 5-HTTLPR and STin2 polymorphisms with substance use disorder. The 
meta-analyses support the associations of 5-HTTLPR with alcohol, heroin,
 cocaine, and methamphetamine dependence and abuse (eg, the smallest 
P-values were 0.0058 with odds ratio (OR)=0.54 (0.35, 0.84); 0.0024 with
 OR=0.77 (0.66, 0.91); 0.018 with OR=1.38 (1.06, 1.81); and 0.028 with 
OR=0.46 (0.23, 0.92) for alcohol, heroin, cocaine, and methamphetamine 
dependence/abuse, respectively). When all the phenotypes are combined, 
the P-value was 0.0006 with OR=0.86 (0.78, 0.94) in the combined 
European, Asian, and Mexican populations and P-value was 0.0028 with 
OR=1.41 (1.13, 1.78) in the African populations. Evidence of significant
 associations was also identified in other subgroup analyses regarding 
differently combined substance and populations. The effect sizes of 
5-HTTLPR were comparable among the European, Asian, and Mexican 
populations, however, the risk allele was more frequent in Asians than 
in Europeans and Mexicans. The opposite directions of risk allele in 
African population might be driven by the opposite directions of risk 
allele in cocaine dependence. This meta-analysis supports that the 
association of the SLC6A4 gene with substance use disorder varies 
depending on substances with different risk allele frequencies in the 
multi-cultural populations. Further studies using larger sample size are
 warranted. 
 
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