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

作者：Lin Chin; Yang Hsin Yi; Wu Chia Chao; Lee Herng Sheng; Lin Yuh Feng; Lu Kuo Cheng; Chu Chi Ming; Lin Fu Huang; Kao Sen Yeong; Su Sui Lung^*

来源：PLos One, 2014, 9(1): e87604.

DOI：10.1371/journal.pone.0087604

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. %26lt;br%26gt;Objectives: This study investigated the gender-dependent effects of ACE I/D polymorphisms on CKD risk. %26lt;br%26gt;Data sources: PubMed, the Cochrane library, and EMBASE were searched for studies published before January 2013. %26lt;br%26gt;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 %26gt;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. %26lt;br%26gt;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%26lt;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. %26lt;br%26gt;Conclusions and implications of key findings: The ACE I/D polymorphisms may incur the highest risk for increasing CKD in hypertensive Asian males.

• 出版日期2014-1-31