Correlation of Angiotensin-I Converting Enzyme Gene Insertion (I), Deletion (D) Polymorphism and Type 2 Diabetic Nephropathy: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 ZUO Yanfang , LONG Aimei , HUANG Xiaoqing , SHEN Mingjing

Longgang District Central Hospital of Shenzhen, Shenzhen 518116, China;

Corresponding author：

ZUO Yanfang, Email: erduan88@163.com

Keywords：

Angiotensin-I converting enzyme gene; Gene polymorphism; Type 2 diabetes mellitus; Diabetic nephropathy; Meta-analysis; Case-control study

DOI：

10.7507/1672-2531.20120167

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Objective 　To perform a meta-analysis and investigate the correlation between angiotensin-I converting enzyme gene insertion (I), deletion (D) polymorphism and type 2 diabetic nephropathy, assessing the bias of small sample size study and heterogeneity between studies.
Methods 　MEDLINE, EBSCO, EMbase, PubMed, CHKD, CNKI, CBM, VIP and WanFang Data were searched (from January 1994 to March 18th 2011) for relevant case-control studies. Two reviewers independently identified the literature according to inclusion and exclusion criteria. Also references of the included literature were retrieved. Then data were extracted and assessed by the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using RevMan 5.0.0 software.
Results 　A total of 61 studies comprising 9 979 cases and 7 252 control subjects were included. There was b evidence of heterogeneity (P lt;0.05, I2=60%) and a random effect model was employed to summarize the data. Results of meta-analysis showed that T2DM patients with II genotype had lower incidences of DN than those with DD+DI genotype (OR=0.65, 95%CI 0.57 to 0.74). The results of subgroup meta-analysis showed that Chinese, Japanese and Brazilians patients with II genotype had lower incidences of DN. However, there were no relation among Caucasus, Middle-East, Indian, Mexican, Korean, and Malaysian patients.
Conclusion 　As for T2DM patients, their angiotensin-I converting enzyme gene insertion (I), deletion (D) polymorphism relates to DN. T2DM patients with II genotype have lower incidences of DN. But the difference of this relation varies with ethnicity.

Citation： ZUO Yanfang,LONG Aimei,HUANG Xiaoqing,SHEN Mingjing. Correlation of Angiotensin-I Converting Enzyme Gene Insertion (I), Deletion (D) Polymorphism and Type 2 Diabetic Nephropathy: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(9): 1071-1075. doi: 10.7507/1672-2531.20120167 Copy

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1. 李咏梅, 齐秀英. 肾素2血管紧张素系统基因多态性与糖尿病肾病的关系. 中国慢性病预防与控制, 2004, 12(2): 92-94.
2. Krolewski AS, Warram JH, Christlieb AR, et al. The changing natural history of nephropathy in type 1 diabetes. Am J Med, 1985, 78(5): 785-794.
3. Lichtenstein MJ, Mulrow CD, Elwood PC. Guidelines for reading case control studies. J Chronic Dis, 1987, 40(9): 893-903.
4. Crook E, Genous L, Oliver B. Angiotensin-converting enzyme genetype in blacks with diabetic nephropathy: effects on risk of diabetes and its complications. Journal of Investigative Medicine, 2003, 51(6): 360-365.
5. 廖岚, 雷闽湘, 陈慧玲, 等. 血管紧张素转换酶基因多态性与2 型糖尿病肾病. 湖南医科大学学报, 2003, 28(6): 553-556.
6. Uddin M, Azam M, Chowdhury N, et al. Angiotensin I-converting enzyme gene polymorphism in type 2 diabetic patients with nephropathy. Med Sci, 2007, 7(4): 682-685.
7. Kumar A, Mohindru K, Sehajpal PK. Angiotensin-I converting enzyme polymorphism and diabetic nephropathy in North India. Int J Hum Genet, 2005, 5(4): 279-283.
8. 阚瑛, 赵焱. 血管紧张素Ⅰ转换酶基因多态性与2型糖尿病肾病的关联性. 吉林大学学报(医学版), 2000, 35(2): 352-355.
9. 顾敏峰, 邓振霞, 唐建英. 血管紧张素Ⅰ转换酶基因多态性与2 型糖尿病肾病的关系. 江苏医药杂志, 2000, 26(3): 169-171.
10. 李鸣, 刘丽梅, 郑泰山, 等. 血管紧张素Ⅰ转换酶基因多态性与2型糖尿病肾病相关性研究. 上海医学, 2004, 27(7): 457-459.
11. 许玲, 张秀英, 马玉燕, 等. 血管紧张素Ⅱ1型受体基因、血管紧张素Ⅰ转化基因多态与2型糖尿病肾病的关系. 山东医科大学学报, 2001, 39(6): 514-516.
12. 赵长霞, 胡东南, 谢翠鹏, 等. 血管紧张素转化酶基因多态性与Ⅱ型糖尿病肾病. 中国航天工业医药, 2001, 3(2): 35-37.
13. 步天栩, 周建新, 李昕, 等. 血管紧张素转化酶基因多态性与Ⅱ型糖尿病肾病的关系. 天津医科大学学报, 2008, 14(3): 293-296.
14. 李咏梅, 齐秀英. 血管紧张素转换酶基因多态性与2型糖尿病肾病的关系. 中国慢性病预防与控制, 2005, 13(1): 12-13.
15. 王群, 马增霞, 邱书娟. 血管紧张素转换酶基因多态性与2型糖尿病肾病的相关性. 山东医药, 2007, 47(26): 71-72.
16. 杨涛, 陈家伟, 周红文, 等. 血管紧张素转换酶基因多态性与早发性糖尿病肾病. 齐齐哈尔医学院学报, 2003, 24(10): 1086-1088.
17. 陈素杰, 周哲, 陈孟芝, 等. 血管紧张素转换酶基因缺失纯合型与糖尿病肾病相关联. 基础医学与临床, 2000, 20(5): 27-29.
18. 庞小芬, 巩云霞, 朱理敏, 等. 血管紧张素Ⅰ转换酶基因多态性与老年人糖尿病及糖尿病肾病的关系. 老年医学与保健, 2001, 7(2): 94-96.
19. 符辉明, 伍汉文, 杨建平, 等. 湘西地区苗族人群糖尿病肾病遗传流行病学调查机血管紧张素转换酶基因多态性研究. 中华肾脏病杂志, 2002, 18(3): 228-229.
20. 谢基明, 王玉珍, 岳秀兰, 等. 内蒙古包头地区汉族人血管紧张素转换酶基因与糖尿病肾病的相关性研究. 内蒙古医学院学报, 2006, 28(1): 14-18.
21. 李博一, 罗平, 文磊. 昆明地区汉族2 型糖尿病肾病与血管紧张素I 转换酶基因多态性的相关性研究. 实用糖尿病杂志, 2006, 3(1): 41-42.
22. 李英, 张艳玲, 丁小颖, 等. 河北地区汉族人血管紧张素转换酶基因与糖尿病肾病的相关性研究. 中国急救医学, 2000, 20(4): 222-223.
23. 廖蕴华, 孙安远, 冼苏, 等. 广西汉族人血管紧张素转换酶Ⅰ基因多态性与2 型糖尿病肾病相关性研究. 临床荟萃, 2002, 17(7): 378-379.
24. 许玲, 王德全, 马玉燕, 等. 血管紧张素I转换酶基因多态和2型糖尿病肾病相关性研究. 中国糖尿病杂志. 1999, 7(3): 138-140.
25. 王健军,　潘颖,　孙林, 等. 血管紧张素É 转化酶基因多态性与老年人2型糖尿病肾病的关系. 中华老年医学杂志, 1999, 18(2): 880-883.
26. 谷定英, 刘毅, 汪大望, 等. 血管紧张素转化酶基因多态性与非胰岛素依赖性糖尿病肾病的关系. 温州医学院学报, 1998, 28(2): 106-108.
27. 陈晓蕾, 罗平, 张建伟, 等. 昆明汉族人群肾素-血管紧张素系统基因多态性与糖尿病肾病的相关性研究. 中国糖尿病杂志, 2010, 18(6): 434-437.
28. 王健军, 潘颖, 孙林, 等. 血管紧张素Ⅰ转换酶基因多态性与Ⅱ型糖尿病肾病. 首都医科大学学报, 1999, 20(3): 174-177.
29. 赵卫红, 王笑云, 丁国宪. 血管紧张素转换酶基因多态性与2型糖尿病肾病的关系. 南京医科大学学报, 1998, 18(6): 477-479.
30. 薛耀明, 成玉斌, 周琳, 等. 血管紧张素Ⅰ转换酶基因多态性与2型糖尿病肾病的易感性及病情发展的相关研究. 第一军医大学学报, 2001, 21(2): 85-87.
31. 关广聚, 吴涛, 文蓉珠, 等. 血管紧张素Ⅰ转换酶基因多态性与糖尿病及糖尿病肾病的关系.中华肾脏病杂志, 1999,15(6): 365-367.
32. 吴松华, 项坤三, 翁青, 等. 糖尿病肾病与血管紧张素Ⅰ转换酶基因多态性的关系. 中华医学杂志, 1997, 77(3): 183-186.
33. 张艳玲, 李英, 顾连方, 等. 河北地区汉族人血管紧张素转换酶基因与糖尿病肾病的相关性研究. 中华肾脏病杂志, I999, 15(1): 40-42.
34. 廖岚, 雷闵湘, 韩秀云, 等. 2型糖尿病肾病与血管紧张素转换酶基因多态性的研究. 中国糖尿病杂志, 1999, 7(6): 337-340.
35. 刘志红, 陈朝红, 关天俊, 等. 血管紧张素转换酶基因多态性与糖尿病和糖尿病肾病的关系. 肾脏病与透析肾移植杂志, 1997, 6(5): 407-410.
36. Ahluwalia TS, Ahuja M, Rai TS, et al. ACE variants interact with the RAS pathway to confer risk and protection against type 2 diabetic nephropathy. DNA Cell Biol, 2009, 28(3): 141-150.
37. Palomo-Pinon S, Gutierrez-Rodriguez ME, Diaz-Flores M, et al. DD genotype of angiotensin-converting enzyme in type 2 diabetes mellitus with renal disease in Mexican Mestizos. Nephrology (Carlton), 2009, 14(2): 235-239.
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Chinese Journal of Evidence-Based Medicine

Correlation of Angiotensin-I Converting Enzyme Gene Insertion (I), Deletion (D) Polymorphism and Type 2 Diabetic Nephropathy: A Meta-Analysis

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