Department of Geriatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Intern Med J. 2012 Apr;42(4):439-44. doi: 10.1111/j.1445-5994.2011.02584.x.
The angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been suggested to influence susceptibility to essential hypertension (EH), but the results of many individual studies are conflicting.
To explore the relationship between the ACE gene I/D polymorphism and EH in the Chinese population, 67 separated studies were analyzed in a meta-analysis including 21,058 participants. The electronic databases PubMed, Embase, Web of Science, China Biological Medicine Database and China National Knowledge Infrastructure were searched. The pooled odds ratio (ORs) and its corresponding 95% confidence interval were calculated by the random effects model.
In this ACE I/D gene polymorphism meta-analysis, the distribution of the D allele frequency was 0.45 for the EH group and 0.40 for the control group. The summary OR for the distribution frequency of D allele was 1.27 (5% confidence interval 1.17-1.37). The heterogeneity among the 67 studies was also significant (P < 0.00001, I(2) = 71.4%). There was a significant association between distribution frequency of the D allele and EH risk in Han, Kazakh, Tibetan, Zhuang and unclassified nationalities (P < 0.05). In contrast, in the national minorities, such as Mongolian, Uigur, Yi, Dongxiang, Yugu, Korean and Gamel, the association between distribution frequency of the D allele and EH risk was not significant (P > 0.05).
In the whole Chinese population, the D allele was significantly linked with EH susceptibility. However, the relation between the I/D polymorphism and EH is still inconclusive in some national minorities and must await larger scale studies.
血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性被认为影响原发性高血压（EH）的易感性，但许多单独研究的结果存在冲突。
为了探讨 ACE 基因 I/D 多态性与中国人 EH 之间的关系，对包括 21058 名参与者的 67 项独立研究进行了荟萃分析。检索了电子数据库 PubMed、Embase、Web of Science、中国生物医学文献数据库和中国国家知识基础设施。采用随机效应模型计算合并优势比（OR）及其相应的 95%置信区间。
在 ACE I/D 基因多态性荟萃分析中，EH 组 D 等位基因频率分布为 0.45，对照组为 0.40。D 等位基因分布频率的汇总 OR 为 1.27（95%置信区间 1.17-1.37）。67 项研究之间的异质性也非常显著（P < 0.00001，I² = 71.4%）。汉族、哈萨克族、藏族、壮族和未分类民族的 D 等位基因分布频率与 EH 风险之间存在显著关联（P < 0.05）。相比之下，蒙古族、维吾尔族、彝族、东乡族、裕固族、朝鲜族和柯尔克孜族等少数民族中，D 等位基因分布频率与 EH 风险之间的关联不显著（P > 0.05）。
在整个中国人群中，D 等位基因与 EH 易感性显著相关。然而，在一些少数民族中，I/D 多态性与 EH 的关系仍不确定，需要更大规模的研究。
