Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, China.
J Assist Reprod Genet. 2012 Sep;29(9):921-32. doi: 10.1007/s10815-012-9800-4. Epub 2012 May 30.
There have been many studies concerning the associations of angiotensin-converting enzyme (ACE) I/D, angiotensinogen (AGT) M235T polymorphisms with pregnancy induced hypertension (PIH) among Chinese populations. However, the results were inconsistent, prompting the necessity of meta-analysis.
Studies published in English and Chinese were mainly searched in EMbase, PubMed and CBM up to January 2012.
Twenty-three studies with 3,551 subjects for ACE I/D and seven studies with 1,296 subjects for AGT M235T were included. Significant associations were found between ACE I/D and PIH under dominant, recessive and allelic models. A separate analysis confined to preeclampsia suggested that ACE I/D was associated with preeclampsia under recessive model and allelic model, but not dominant model. Stratified analyses were conducted as meta-regression analysis indicated that the sample size of case group was a significant source of heterogeneity, which suggested no significant association between ACE I/D and PIH in the subgroup of more than 100 cases. Associations were found between AGT M235T and PIH under dominant genetic model (OR = 1.59; 95 %CI: 1.04-2.42), recessive genetic model (OR = 1.60; 95 %CI: 1.07-2.40), and allelic model (OR = 1.40; 95 %CI: 1.17-1.68). No publication bias was found in either meta-analysis.
The present meta-analysis suggested significant associations between ACE I/D, AGT M235T and PIH in Chinese populations. However, no significant association was found between ACE I/D and PIH in the subgroup of more than 100 cases. Studies with larger sample sizes are necessary to investigate the associations between gene polymorphisms and PIH in Chinese populations.
已有许多研究探讨血管紧张素转换酶(ACE)I/D、血管紧张素原(AGT)M235T 多态性与中国人妊娠高血压(PIH)的相关性。然而,结果并不一致,这促使我们有必要进行荟萃分析。
主要检索 EMbase、PubMed 和 CBM 中发表的英文和中文研究,检索时间截至 2012 年 1 月。
共纳入 23 项 ACE I/D 研究(3551 例)和 7 项 AGT M235T 研究(1296 例)。在显性、隐性和等位基因模型下,ACE I/D 与 PIH 显著相关。一项仅限于子痫前期的单独分析表明,ACE I/D 与隐性模型和等位基因模型下的子痫前期相关,但与显性模型无关。分层分析表明,meta 回归分析提示病例组的样本量是异质性的一个重要来源,这表明 ACE I/D 与 PIH 在病例数超过 100 的亚组中无显著相关性。在显性遗传模型(OR=1.59;95%CI:1.04-2.42)、隐性遗传模型(OR=1.60;95%CI:1.07-2.40)和等位基因模型(OR=1.40;95%CI:1.17-1.68)下,AGT M235T 与 PIH 显著相关。两种荟萃分析均未发现发表偏倚。
本荟萃分析提示 ACE I/D、AGT M235T 与中国人 PIH 之间存在显著相关性。然而,在病例数超过 100 的亚组中,ACE I/D 与 PIH 之间无显著相关性。需要更大样本量的研究来探讨中国人基因多态性与 PIH 的相关性。