Association between microsatellite polymorphism in the Heme Oxygenase-1 (HMOX1) gene promoter and type 2 diabetes: an updated meta-analysis.

Over a decade has passed since the first meta-analysis examining (GT)n repeats in the HMOX1 promoter region and their association with Type 2 Diabetes (T2D) was conducted. Since then, new studies on this topic have been published, prompting this updated meta-analysis to further clarify these associations. A systematic review conducted through December 2024 using the search term: (HMOX1 OR HMOX1 OR HMOX1D OR "HO-1" OR HSP32 OR bk286B10) AND (polymorphisms OR polymorphism OR "genetic variant" OR "genetic variants") AND (Diabetes) in the PubMed, Web of Science, and Scopus databases identified nine studies comprising 2,027 cases and 2,840 controls. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using either a fixed-effect model (FEM) for homogeneous data or a random-effect model (REM) for other cases, as appropriate. Sensitivity analysis and publication bias were also assessed. The SS genotype was identified as being inversely associated with T2D in both SS:SL + LL and SS:LL genetic models (OR = 0.769, p = 0.003; OR = 0.726, p = 0.003; respectively). These findings suggest that SS genotype (< 25 GT repeats) may have a protective role against T2D; however, further studies are needed to elucidate the mechanisms by which HMOX1 influences T2D pathogenesis.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01575-y.