血管紧张素转换酶插入/缺失多态性增加亚洲男性高血压患者慢性肾脏病风险——98 项观察性研究的荟萃回归分析。
Angiotensin-converting enzyme insertion/deletion polymorphism contributes high risk for chronic kidney disease in Asian male with hypertension--a meta-regression analysis of 98 observational studies.
机构信息
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
出版信息
PLoS One. 2014 Jan 31;9(1):e87604. doi: 10.1371/journal.pone.0087604. eCollection 2014.
BACKGROUND
Associations between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and chronic kidney disease (CKD) have been extensively studied, with most studies reporting that individuals with the D allele have a higher risk. Although some factors, such as ethnicity, may moderate the association between ACE I/D polymorphisms and CKD risk, gender-dependent effects on the CKD risk remain controversial.
OBJECTIVES
This study investigated the gender-dependent effects of ACE I/D polymorphisms on CKD risk.
DATA SOURCES
PubMed, the Cochrane library, and EMBASE were searched for studies published before January 2013.
STUDY ELIGIBILITY CRITERIA PARTICIPANTS AND INTERVENTIONS
Cross-sectional surveys and case-control studies analyzing ACE I/D polymorphisms and CKD were included. They were required to match the following criteria: age >18 years, absence of rare diseases, and Asian or Caucasian ethnicity.
STUDY APPRAISAL AND SYNTHESIS METHODS
The effect of carrying the D allele on CKD risk was assessed by meta-analysis and meta-regression using random-effects models.
RESULTS
ETHNICITY [ODDS RATIO (OR): 1.24; 95% confidence interval (CI): 1.08-1.42] and hypertension (OR: 1.55; 95% CI: 1.04-2.32) had significant moderate effects on the association between ACE I/D polymorphisms and CKD risk, but they were not significant in the diabetic nephropathy subgroup. Males had higher OR for the association between ACE I/D polymorphisms and CKD risk than females in Asians but not Caucasians, regardless of adjustment for hypertension (p<0.05). In subgroup analyses, this result was significant in the nondiabetic nephropathy group. Compared with the I allele, the D allele had the highest risk (OR: 3.75; 95% CI: 1.84-7.65) for CKD in hypertensive Asian males.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
The ACE I/D polymorphisms may incur the highest risk for increasing CKD in hypertensive Asian males.
背景
血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性与慢性肾脏病（CKD）之间的关联已被广泛研究，大多数研究报告表明，携带 D 等位基因的个体患该病的风险更高。尽管一些因素，如种族，可能会调节 ACE I/D 多态性与 CKD 风险之间的关联，但性别对 CKD 风险的影响仍存在争议。
目的
本研究旨在探讨 ACE I/D 多态性对 CKD 风险的性别依赖性影响。
数据来源
检索了截至 2013 年 1 月发表的 PubMed、Cochrane 图书馆和 EMBASE 中的研究。
研究入选标准
纳入的研究为分析 ACE I/D 多态性与 CKD 的横断面调查和病例对照研究，必须符合以下标准：年龄＞18 岁、无罕见疾病、为亚洲或高加索人种。
研究评估和综合分析方法
使用随机效应模型的荟萃分析和荟萃回归来评估携带 D 等位基因对 CKD 风险的影响。
结果
种族[比值比（OR）：1.24；95%置信区间（CI）：1.08-1.42]和高血压（OR：1.55；95% CI：1.04-2.32）对 ACE I/D 多态性与 CKD 风险之间的关联有显著的中等影响，但在糖尿病肾病亚组中无显著影响。在亚洲人群中，男性 ACE I/D 多态性与 CKD 风险之间的关联的 OR 高于女性，而在高加索人群中则不然，无论是否调整高血压因素（P＜0.05）。在亚组分析中，在非糖尿病肾病组中这一结果具有统计学意义。与 I 等位基因相比，D 等位基因使高血压的亚洲男性患 CKD 的风险最高（OR：3.75；95% CI：1.84-7.65）。
结论和关键发现的意义
ACE I/D 多态性可能会使高血压的亚洲男性患 CKD 的风险最高。
Zotero 插件