科研之友
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摘要
Background: Evidence has suggested that angiotensin-converting enzyme (ACE) may be involved in the etiology of primary intracerebral hemorrhage (PICH), but the underlying association between ACE I/D (rs4646994) polymorphism and PICH risk is still ambiguous. This meta-analysis was performed to quantitatively summarize the evidence for such a relationship. Methods: Eligible studies were identified by searching PubMed, EMBASE, CNKI (China National Knowledge Infrastructure), CBM (Chinese biomedical literature database), and WANFANG databases within a range of published years from 1990 to August 2012. The odds ratio (OR) corresponding to the 95% confidence interval (CI) was used to assess the different associations. Results: A total of 28 studies with 2806 cases and 3612 controls were included in this meta-analysis. The pooled examination displayed an overall increased PICH risk associated with ACE I/D polymorphism in a recessive model (OR = 1.80, 95% CI = 1.39-2.33, P < 0.001 for DD versus ID/II), however, this association was only present in Asians (OR = 1.91, 95% CI = 1.45-2.51, P < 0.001) and not in Caucasians (OR = 1.16, 95% CI = 0.55-2.44, P = 0.69). Hypertensive intracerebral hemorrhage (HICH) had a much greater risk (OR = 4.26, 95% CI = 2.87-6.32, P < 0.001) than general PICH (OR = 1.65, 95% CI = 1.25-2.18, P < 0.001) in Asians, and subgroup with controls excluding hypertension had a greater risk (OR = 2.65, 95% CI = 1.78-3.95, P < 0.001) than that including hypertension (OR = 1.50, 95% CI = 1.12-2.02, P = 0.01). Conclusions: This meta-analysis suggests that DD homozygote of ACE I/D polymorphism has an increased PICH risk in Asians, and may have a synergistic effect with hypertension.
