Elkins Jacob S, Douglas Vanja C, Johnston S Claiborne
Department of Neurology, University of California, San Francisco, CA 94143-0114, USA.
Neurology. 2004 Feb 10;62(3):363-8. doi: 10.1212/01.wnl.0000106823.72493.ff.
Numerous studies have tested for associations between common variants of the angiotensin-converting enzyme gene (ACE) and late-onset Alzheimer disease (AD), but results have been inconclusive.
Relevant studies were systematically identified, and data were abstracted according to predefined criteria.
The odds ratio (OR) for AD in individuals with the I allele of the ACE D/I polymorphism compared with those with the DD genotype was 1.27 (95% CI, 1.10 to 1.47; p < 0.001). Heterogeneity between studies was significant (p < 0.001) but not in strata defined by race and age (p > or = 0.10). The risk of AD associated with the I allele appeared to be higher among Asians (OR 2.44; 95% CI, 1.68 to 3.53) when compared with the risk among Caucasians (OR 1.18; 95% CI, 1.02 to 1.37) (p for comparison < 0.001), and in younger cases (mean age 65 to 74 years) (OR 1.54; 95% CI, 1.23 to 1.93) when compared with the risk in older cases (OR 1.13; 95% CI, 0.95 to 1.35) (p for comparison = 0.03).
The I allele of the ACE D/I polymorphism is associated with an increased risk of late-onset AD. Further study of the pathogenetic characteristics of this allele and independent confirmation of the association in larger studies are warranted.
众多研究检测了血管紧张素转换酶基因（ACE）常见变异与晚发型阿尔茨海默病（AD）之间的关联，但结果尚无定论。
系统检索相关研究，并根据预定义标准提取数据。
与DD基因型个体相比，携带ACE D/I多态性I等位基因的个体患AD的比值比（OR）为1.27（95%可信区间[CI]，1.10至1.47；p<0.001）。研究间的异质性显著（p<0.001），但在按种族和年龄定义的亚组中无显著异质性（p≥0.10）。与白种人（OR 1.18；95%CI，1.02至1.37）相比，亚洲人携带I等位基因患AD的风险似乎更高（OR 2.44；95%CI，1.68至3.53）（比较p<0.001）；与老年患者（OR 1.13；95%CI，0.95至1.35）相比，年轻患者（平均年龄65至74岁）携带I等位基因患AD的风险更高（OR 1.54；95%CI，1.23至1.93）（比较p = 0.03）。
ACE D/I多态性的I等位基因与晚发型AD风险增加相关。有必要进一步研究该等位基因的致病特征，并在更大规模研究中独立验证这种关联。
