CHAPITRE 2 — HYPOTHÈSES, OBJECTIFS ET MÉTHODOLOGIE
4.3. VALIDITÉ EXTERNE DE L’ÉTUDE
Les résultats de l’étude ne peuvent pas être extrapolés à des populations autres que caucasiennes, car pour éviter le biais de stratification génétique, la population d’étude a été limitée aux participantes caucasiennes. La population de la ville de Québec n’est pas d’une grande diversité génétique, les participantes non caucasiennes qui ont été exclues de notre étude représentaient que 3 % de notre échantillon. Puisque les fréquences des allèles des gènes du CYP450 varient selon les groupes ethniques (Zhou, Liu, & Chowbay, 2009), notre étude d’interaction devrait être reproduite dans des populations d’une plus grande diversité ethnique en stratifiant pour l’ethnicité ou en restreignant l’étude à des sous-populations homogènes sur la race (autre que caucasienne). Cependant, la stratification nécessiterait une plus grande taille d’échantillon.
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CONCLUSION
Cette étude visait à mieux caractériser les mécanismes biologiques qui pourraient expliquer un lien de causalité entre l’exposition maternelle aux SPCs et le RCIU. Elle suggère que les SNPs étudiés des gènes CYP1A2, CYP2A6, CYP2D6 et CYP17A1 n’auraient pas d’effet sur le PPAG ainsi qu’aucun effet modifiant sur l’association entre l’exposition maternelle aux SPCs et le PPAG. Toutefois, la faible puissance statistique et les possibles erreurs de classement non différentielles pourraient être la cause d’une absence d’associations et d’interactions statistiquement significatives. En outre les analyses d’interaction et d’association étaient limitées pour les gènes CYP1A2, CYP2A6 et CYP2D6 en raison du faible nombre de SNPs qui avaient pu être génotypés. Dans le futur, l’étude de l’interaction gène-environnement pourrait être étendue aux sous-produits de désinfection émergents comme les haloacétonitriles et haloaldéhydes qui n’ont encore jamais été étudiés dans cette perspective.
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