Objective To investigate the associations between the polymorphisms in CD40‐1C/T polymorphism(rs1883832) and Graves′disease by Meta‐analysis .Methods We searched Pubmed ,CBM ,VIP ,CNKI ,Cochrane library and Wanfang ,covering and selecting literatures according to criterions .Statistical analysis was performed by using Revman5 .2 and Stata12 .0 .Results A total of 18 eligible literatures were included(5 198 cases and 4 417 controls) ,The pooling results suggested that significant differ‐ence in allele C/T frequency and genotype frequency were observed between patients with and control subjects (P<0 .05);the indi‐viduals of genotype CC and(or) CT have significantly increased Graves′disease risk(CC vs .TT :OR=1 .60 ,95% CI=1 .28-2 .00 , P<0 .01;CC vs .CT :OR=1 .25 ,95% CI=1 .14 -1 .37 ,P<0 .01 ;CC vs .CT+ TT :OR=1 .34 ,95% CI=1 .17 -1 .52 ,P<0 .01 ;CC+CT vs .TT :OR= 1 .36 ,95% CI= 1 .13 -1 .64 ,P< 0 .01) .From subgroup analysis ,we identified that the research subjects difference showed between thyroid anti‐body(Ab ± ) and thyroid anti‐body (Ab -) in control group ,which might be the cause of heterogeneity ,but the pooling results in sensitivity analysis were stable and no significant publication bias were found .No significant difference in allele and genotype frequency of CD40 SNP were observed between Graves′disease with ophthalmopathy group and Graves′disease without ophthalmopathy group ,Graves′disease with family history group and Graves′disease without family histo‐ry group(all P>0 .05) .Conclusion This Meta analysis indicated that the polymorphisms in the CD40 gene(rs1883832) was related with Graves′disease ,but had nothing to do with family history and Graves′disease with ophthalmopathy .

Objective:To explore the relationship between the long-term dynamic change in alanine aminotransferase(ALT) level and metabolic associated fatty liver disease(MAFLD).Methods:A retrospective study was conducted on 6 864 subjects who underwent four consecutive physical examinations from 2017 to 2020 in a cohort study of physical examination population in Henan Province. The relation between ALT level and the shift of MAFLD risk was analyzed using a multi-state Markov model, and the bidirectional relationship between ALT level and MAFLD was explored using a random intercept cross-lagged model.Results:Multi-state Markov model after adjusting for confounding factors showed that the risk of MAFLD in ALT Q2, Q3, Q4 group was gradually higher than that in Q1 group; Compared with health status, non-alcoholic fatty liver disease and MAFLD status gradually increased the risk of ALT shifting from normal to abnormal. The random intercept cross-lagged model after adjusting for confounding factors showed that there was a significant positive bidirectional relationship between MAFLD and ALT level. The cross-lag effect of MAFLD→ALT level was 0.083(95% CI 0.078-0.087), and the cross-lag effect of ALT→MAFLD was 0.044(95% CI 0.039-0.050). And with the extension of time, the cross-lag effect gradually decreased. Conclusions:There is a significant bidirectional relationship between the long-term dynamic change of ALT level and MAFLD. The occurrence of MAFLD is more likely to increase the risk of elevated ALT level, emphasizing the need for enhanced early prevention and treatment of MAFLD.