血管紧张素转换酶基因多态性与糖尿病肾病的关系：一项包含 26580 例患者的荟萃分析。
Association between genetic polymorphism of the angiotensin-converting enzyme and diabetic nephropathy: a meta-analysis comprising 26,580 subjects.
机构信息
JiangSu Provincial Center for Disease Prevention and Control, Nanjing, China.
出版信息
J Renin Angiotensin Aldosterone Syst. 2012 Mar;13(1):161-74. doi: 10.1177/1470320311417655. Epub 2011 Aug 2.
INTRODUCTION
The effect of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on risk of diabetic nephropathy (DN) is still conflicting. The present meta-analysis was performed to evaluate the overall risk of this polymorphism associated with DN in different groups.
MATERIALS AND METHODS
A predefined search was performed on 14,108 DN cases and 12,472 controls from 63 published studies by searching electronic databases and reference lists of relevant articles.
RESULTS
In this meta-analysis, we found a significant association between the ACE I/D polymorphism and the risk of DN for all genetic models (ID versus II: odds ratio [OR] = 1.12, 95% confidence interval [CI] 1.02-1.24; DD versus II: OR = 1.27, 95% CI 1.13-1.44; allele contrast: OR = 1.15, 95% CI 1.08-1.23; dominant model: OR = 1.18, 95% CI 1.07-1.31; and recessive model: OR = 1.18, 95% CI 1.08-1.30, respectively). In stratified analysis by ethnicity and DM type, we further found that the Asian group with type 2 diabetes mellitus (T2DM) showed a significant association for all genetic models (ID versus II: OR = 1.25, 95% CI 1.07-1.47; DD versus II: OR = 1.57, 95% CI 1.24-1.98; allele contrast: OR = 1.30, 95% CI 1.15-1.46; dominant model: OR = 1.37, 95% CI 1.10-1.69; and recessive model: OR = 1.34, 95% CI 1.15-1.56, respectively).
CONCLUSIONS
Our study suggested that the ACE I/D polymorphism may contribute to DN development, especially in the Asian group with T2DM.
简介
血管紧张素转换酶（ACE）插入/缺失（I/D）多态性对糖尿病肾病（DN）风险的影响仍存在争议。本荟萃分析旨在评估该多态性与不同人群中 DN 相关的总体风险。
材料和方法
通过检索电子数据库和相关文章的参考文献列表，对 63 项已发表研究中的 14108 例 DN 病例和 12472 例对照进行了预先设定的搜索。
结果
在这项荟萃分析中，我们发现 ACE I/D 多态性与 DN 的风险之间存在显著关联，所有遗传模型均如此（ID 与 II：比值比[OR] = 1.12，95%置信区间[CI] 1.02-1.24；DD 与 II：OR = 1.27，95% CI 1.13-1.44；等位基因对比：OR = 1.15，95% CI 1.08-1.23；显性模型：OR = 1.18，95% CI 1.07-1.31；隐性模型：OR = 1.18，95% CI 1.08-1.30）。按种族和 DM 类型进行分层分析后，我们还发现，2 型糖尿病（T2DM）的亚洲人群所有遗传模型均显示出显著关联（ID 与 II：OR = 1.25，95% CI 1.07-1.47；DD 与 II：OR = 1.57，95% CI 1.24-1.98；等位基因对比：OR = 1.30，95% CI 1.15-1.46；显性模型：OR = 1.37，95% CI 1.10-1.69；隐性模型：OR = 1.34，95% CI 1.15-1.56）。
结论
我们的研究表明，ACE I/D 多态性可能导致 DN 的发生，尤其是在亚洲 T2DM 人群中。
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