Xu Hai-Yan, Liu Ming-Ming, Wang Xu, He Xue-Yuan
a The First Clinical Medical College, Nanjing University of Chinese Medicine , Nanjing , China.
b Department of Endocrinology , Xuzhou Traditional Chinese Medicine Hospital , Xuzhou , China.
Ren Fail. 2016 Oct;38(9):1320-1327. doi: 10.1080/0886022X.2016.1216707. Epub 2016 Aug 8.
This study aimed to systematically evaluate the effect of an angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism on type 1 diabetic nephropathy (DN).
Cochrane Library, Embase, PubMed, Science Direct, Web of science, Wanfang data, VIP database, China Knowledge Resource Integrated Database, and SinoMed were searched. A total of 17 case-control studies analyzing ACE I/D polymorphism and type 1 DN risk were included in the present meta-analysis.
Overall, a significant increased risk was found in allele comparison (OR = 1.16, 95% CI = 1.05-1.28, p = 0.04), dominant comparison (OR = 1.56, 95% CI = 1.14-2.15, p = 0.006) and homozygote comparison (OR = 1.52, 95% CI = 1.06-2.19, p = 0.02). In subgroup analyses according to ethnicity, the risk of type 1 DN in Asian population was increased in allele comparison (OR = 1.98, 95% CI = 1.15-3.42, p = 0.01), recessive comparison (OR = 2.48, 95% CI = 1.51-4.10, p = 0.0004), dominant comparison (OR = 3.15, 95% CI = 1.90-5.23, p < 0.00001), and homozygote comparison (OR = 2.87, 95% CI = 1.02-8.06, p = 0.05). However, there was no association between the ACE I/D genetic variants and type 1 DN in Caucasian populations.
Our meta-analysis results indicate that the ACE I/D polymorphism may contribute to type 1 DN development, especially in the Asian groups with type 1 diabetes. The current findings need to be confirmed by future well-designed and larger sample size primary studies in populations with different ethnicities.
本研究旨在系统评价血管紧张素转换酶（ACE）插入/缺失（I/D）基因多态性对1型糖尿病肾病（DN）的影响。
检索Cochrane图书馆、Embase、PubMed、Science Direct、Web of science、万方数据、维普数据库、中国知网和中国生物医学文献数据库。本荟萃分析共纳入17项分析ACE I/D多态性与1型DN风险的病例对照研究。
总体而言，在等位基因比较（OR = 1.16，95%CI = 1.05 - 1.28，p = 0.04）、显性比较（OR = 1.56，95%CI = 1.14 - 2.15，p = 0.006）和纯合子比较（OR = 1.52，95%CI = 1.06 - 2.19，p = 0.02）中发现风险显著增加。在按种族进行的亚组分析中，亚洲人群中1型DN的风险在等位基因比较（OR = 1.98，95%CI = 1.15 - 3.42，p = 0.01）、隐性比较（OR = 2.48，95%CI = 1.51 - 4.10，p = 0.0004）、显性比较（OR = 3.15，95%CI = 1.90 - 5.23，p < 0.00001）和纯合子比较（OR = 2.87，95%CI = 1.02 - 8.06，p = 0.05）中增加。然而，在白种人群中，ACE I/D基因变异与1型DN之间没有关联。
我们的荟萃分析结果表明，ACE I/D多态性可能促成1型DN的发生，尤其是在亚洲1型糖尿病患者群体中。目前的研究结果需要未来在不同种族人群中进行设计良好且样本量更大的初步研究来证实。
