Background: In view of the controversies about the skewed X chromosome inactivation (XCI) and premature ovarian failure (POF) association, a meta-analysis of the published data was performed to evaluate the relationship between XCI skewing and POF.
Methods: We searched for all published articles indexed in MEDLINE (1950 approximately 2009) and CNKI (1994 approximately 2009). Any case-control or cohort study that tested the association between skewed XCI and POF was included and data were extracted independently by two reviewers. We performed this meta-analysis involving 325 cases and 403 controls with Review Manager 4.2 software.
Results: Four eligible studies were selected for meta-analysis. It suggested that there was no significant difference between the incidence of skewed XCI (XCI >or=70% skewing) in POF cases comparing to healthy controls, odds ratio (OR) = 1.13 [95% confidence interval (CI): 0.84 approximately 1.53, P = 0.42]. The link between extremely skewed XCI (XCI >or=90% skewing) and POF was also analysed, and no significant difference was found, either, OR = 1.46 (95% CI: 0.79 approximately 2.69, P = 0.22).
Conclusions: Skewed XCI had no association with POF. However, more case-control and cohort studies are needed in the future.