Department of Obstetrics, Maternal and Child Health Hospital of Weifang, Weifang 261011, China.
Metabolism. 2013 Sep;62(9):1227-38. doi: 10.1016/j.metabol.2013.03.003. Epub 2013 Jul 11.
Many studies have investigated the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and risk of recurrent miscarriage, but the impact is unclear due to inconsistencies among those studies. This study aimed to quantify the strength of the association between ACE I/D polymorphism and recurrent miscarriage risk by performing a systematic review and meta-analysis.
We searched PubMed, Embase, Web of Science, and Wanfang Medicine databases for eligible articles relating the association between ACE I/D polymorphism and risk of recurrent miscarriage in humans. We estimated the summary odds ratios (ORs) with their 95% confidence intervals (95% CIs) to assess the association.
Eleven studies with a total of 3357 individuals were included in this meta-analysis. Compared to the ACE II genotype, DD and ID were both associated with increased risk of recurrent miscarriage (OR DD versus II=1.81, 95% CI 1.23-2.66, P=0.003; OR ID versus II=1.50, 95% CI 1.25-1.80, P<0.001). Sensitivity analyses further confirmed the association above. No evidence of publication bias was observed.
Meta-analyses of available data show a significant association between ACE I/D polymorphism and recurrent miscarriage risk, and the ACE polymorphic D allele contributes to increased risk of recurrent miscarriage.
许多研究已经调查了血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性与复发性流产风险之间的关系，但由于这些研究之间存在不一致，其影响尚不清楚。本研究旨在通过系统评价和荟萃分析来量化 ACE I/D 多态性与复发性流产风险之间的关联强度。
我们检索了 PubMed、Embase、Web of Science 和万方医学数据库，以获取有关 ACE I/D 多态性与人类复发性流产风险之间关联的相关文章。我们使用汇总优势比（OR）及其 95%置信区间（95%CI）来评估关联。
这项荟萃分析纳入了 11 项共 3357 名个体的研究。与 ACE II 基因型相比，DD 和 ID 均与复发性流产风险增加相关（OR DD 与 II=1.81，95%CI 1.23-2.66，P=0.003；OR ID 与 II=1.50，95%CI 1.25-1.80，P<0.001）。敏感性分析进一步证实了上述关联。未观察到发表偏倚的证据。
对现有数据的荟萃分析表明，ACE I/D 多态性与复发性流产风险之间存在显著关联，ACE 多态性 D 等位基因增加了复发性流产的风险。
