Sleep Disorders Center, National Taiwan University Hospital, Taipei, Taiwan.
Eur Respir J. 2012 Aug;40(2):394-9. doi: 10.1183/09031936.00100211. Epub 2011 Dec 19.
Obstructive sleep apnoea (OSA) is an independent risk factor for hypertension. Increased angiotensin-converting enzyme (ACE) activity may be a possible promoting mechanism with different ACE insertion/deletion (I/D) genotypes influencing this activity. Studies investigating the association of ACE I/D polymorphisms with OSA have shown conflicting results. We aimed to undertake a meta-analysis of existing studies exploring the association of ACE I/D polymorphisms with the risk of OSA and hypertension. 10 studies were included in a random effects meta-analysis, comprising 1,227 OSA subjects and 1,227 controls. The effect size was measured using the odds ratio. The risk of having OSA in carriers of the D allele was 0.92 (95% CI 0.69-1.23). There was statistically significant heterogeneity across the studies (I(2)=42%, p=0.08 and I(2)=74%, p<0.0001 for genotype and allele frequency, respectively). The association of D allele frequency with the risk of OSA remained nonsignificant after stratification based on ethnicity, source of population sample, and the presence of hypertension. Subgroup analysis failed to show any influence of genotype and allele frequency on OSA severity. This meta-analysis revealed no association between the ACE I/D polymorphisms and OSA susceptibility.
阻塞性睡眠呼吸暂停（OSA）是高血压的独立危险因素。血管紧张素转换酶（ACE）活性增加可能是一种潜在的促进机制，不同的 ACE 插入/缺失（I/D）基因型影响这种活性。研究表明 ACE I/D 多态性与 OSA 之间存在关联，但结果相互矛盾。我们旨在对现有的研究进行荟萃分析，以探讨 ACE I/D 多态性与 OSA 和高血压风险之间的关系。10 项研究被纳入随机效应荟萃分析，包括 1227 名 OSA 患者和 1227 名对照。使用比值比来衡量效应大小。携带 D 等位基因的个体患 OSA 的风险为 0.92（95%CI 0.69-1.23）。研究之间存在统计学上显著的异质性（基因型和等位基因频率的 I(2)值分别为 42%，p=0.08 和 74%，p<0.0001）。基于种族、人群样本来源和高血压的存在对 D 等位基因频率与 OSA 风险的相关性进行分层后，这种相关性仍然不显著。亚组分析未能显示基因型和等位基因频率对 OSA 严重程度有任何影响。本荟萃分析表明 ACE I/D 多态性与 OSA 易感性之间无关联。
