Association between the Insertion/Deletion Polymorphism of ACE Gene and Athlete's Sport Performance in Endurance Sports: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 AIJin-wei ^1,2 , LIUYing ² , LIDe-sheng ² , LIUYu ² ,  PEIBin ^1,2

1. Evidence-Based Medicine Center, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, China;
2. Department of Micro-orthopedic Surgery, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, China;

Corresponding author：

PEIBin, Email: xyxzyxzx@163.com

Keywords：

Peptidyl-dipeptidase A; Polymorphism; Athlete; Endurance sports; Meta-analysis

DOI：

10.7507/1672-2531.20160062

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the association between the insertion/deletion (I/D) polymorphism of angiotension-converting enzyme (ACE) gene and the athletes' performance in endurance sports. Methods Databases including PubMed, EMbase, CNKI, CBM, VIP, and WanFang Data were searched up to August 1^st, 2015 to collect case-control studies about the association between ACE I/D polymorphism and the athletes' performance in endurance sports. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 37 case-control studies involving 3 032 athletes and 10 857 controls were included. The results of meta-analysis showed that significant association was found between ACE I/D polymorphism and the athletes' performance in endurance sports (DD+DI vs. Ⅱ: OR=0.75, 95%CI 0.67 to 0.83, P<0.01; DD vs. Ⅱ: OR=0.73, 95%CI 0.61 to 0.87, P<0.01; DI vs. Ⅱ: OR=0.74, 95%CI 0.66 to 0.83, P<0.01; D vs. Ⅰ: OR=0.85, 95%CI 0.77 to 0.94, P<0.01). Specifically, the ACE I/D polymorphism was significantly associated with the performance of male athletes in endurance sports (DD+DI vs. Ⅱ: OR=0.73, 95%CI 0.61 to 0.88, P<0.01; DD vs. Ⅱ: OR=0.75, 95%CI 0.60 to 0.93, P=0.01; DI vs. Ⅱ: OR=0.70, 95%CI 0.60 to 0.93, P<0.01; D vs. Ⅰ: OR=0.87, 95%CI 0.77 to 0.97, P=0.01). Subgroup analysis of ethnicity showed that, in Caucasians, except for genetic model DD vs. DI+Ⅱ, the other 4 genetic models were significantly associated with the athletes' performance in endurance sports (DD+DI vs. Ⅱ: OR=0.74, 95%CI 0.65 to 0.84, P<0.01; DD vs. Ⅱ: OR=0.72, 95%CI 0.58 to 0.90, P<0.01; DI vs. Ⅱ: OR=0.73, 95%CI 0.64 to 0.84, P<0.01; D vs. Ⅰ: OR=0.87, 95%CI 0.81 to 0.94, P<0.01); in Africans, significant associations with the athletes' performance in endurance sports were found in genetic model DD vs. DI+Ⅱ (OR=0.75, 95%CI 0.57 to 0.98, P=0.04), genetic model DD vs. Ⅱ (OR=0.62, 95%CI 0.42 to 0.92, P=0.02), and genetic model D vs. Ⅰ (OR=0.80, 95%CI 0.66 to 0.96, P=0.02); in Asians, no significant association was found between ACE I/D polymorphism and the performance of athletes of difference races in endurance sports. Conclusion Current evidence indicates that the ACE I/D polymorphism may be associated with the performance of athletes especially male athletes and the Caucasian subgroup in endurance sports. ACE allele D is negatively associated with the athletes' performance in endurance sports, while allele I is positively associated with the athletes' performance in endurance sports. Due to the quality limitations of included studies, more high quality case-control or cohort studies are needed to verify the above conclusions.

Citation： AIJin-wei, LIUYing, LIDe-sheng, LIUYu, PEIBin. Association between the Insertion/Deletion Polymorphism of ACE Gene and Athlete's Sport Performance in Endurance Sports: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 392-402. doi: 10.7507/1672-2531.20160062 Copy

1.	邓文骞, 王璐, 左天香, 等. 耐力素质与力量素质相关基因的研究进展. 四川体育科学, 2007, 4(1):34-37.
2.	杨若愚, 王予彬, 沈勋章, 等. 基因多态性与杰出运动能力. 中国组织工程研究, 2014, 18(7):1121-1128.
3.	Payne J, Montgomery H. Genetic variation and physical performance. World Rev Nutr Diet, 2004, 93:270-302.
4.	左彦方, 龙爱梅, 黄晓青, 等. 血管紧张素转换酶基因多态性与2型糖尿病肾病相关性的Meta分析. 中国循证医学杂志, 2012, 12(9):1071-1075.
5.	吴晓梅, 时玥, 时景璞. 中国汉族人群脑出血患者血管紧张素转换酶基因插入/缺失多态性的Meta分析. 中国循证医学杂志, 2009, 9(12):1323-1327.
6.	Gayagay G, Yu B, Hambly B, et al. Elite endurance athletes and the ACE Ⅰ allele——the role of genes in athletic performance. Hum Genet, 1998, 103(1):48-50.
7.	Hagberg J, Rankinen T, Loos R, et al. Advances in exercise, fitness, and performance genomics in 2010. Med Sci Sports Exer, 2011, 43(5):743-752.
8.	Guth LM, Roth SM. Genetic influence on athletic performance. Curr Opin Pediatr, 2013, 25(6):653-658.
9.	杨贤罡, 扬胡. ACE基因I/D多态性与耐力素质的关联性研究:Meta分析. 体育科学, 2010, 30(7):42-49.
10.	Ma F, Yang Y, Li X, et al. The association of sport performance with ACE and ACTN3 genetic polymorphisms:a systematic review and meta-analysis. PLoS One, 2013, 8(1):e54685.
11.	张明军, 叶学球. 中国汉族成年运动员ACE基因多态性与运动能力的Meta分析. 惠州学院学报, 2015, 35(3):109-116.
12.	Moher D, Liberati A, Tetzlaff J, et al. Reprint——preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. Phys Ther, 2009, 89(9):873-880.
13.	曾宪涛, 高岭, 刘得玺, 等. 牙周病与口腔癌相关性的Meta分析. 湖北医药学院学报, 2012, 31(05):390-394.
14.	Woods D, Hickman M, Jamshidi Y, et al. Elite swimmers and the D allele of the ACE I/D polymorphism. Hum Genet, 2001, 108(3):230-232.
15.	Papadimitriou ID, Papadopoulos C, Kouvatsi A, et al. The ACE I/D polymorphism in elite Greek track and field athletes. J Sports Med Phys Fitness, 2009, 49(4):459-463.
16.	Shahmoradi S, Ahmadalipour A, Salehi M. Evaluation of ACE gene I/D polymorphism in Iranian elite athletes. Adv Biomed Res, 2014, 3(1):207-213.
17.	Costa A, Silva A, Garrido N, et al. Association between ACE D allele and elite short distance swimming. Eur J Appl Physiol, 2009, 106(6):785-790.
18.	Amir O, Amir R, Yamin C, et al. The ACE deletion allele is associated with Israeli elite endurance athletes. Exp Physiol, 2007, 92(5):881-886.
19.	Gómez-Gallego F, Santiago C, González-Freire G, et al. Endurance performance:genes or gene combinations? Int J Sports Med, 2008, 30(1):66-72.
20.	Tanriverdi H, Evrengul H, Tanriverdi S, et al. Improved endothelium dependent vasodilation in endurance athletes and its relation with ACE I/D polymorphism. Circ J, 2005, 69(9):1105-1110.
21.	Shenoy S, Tandon S, Sandhu J, et al. Association of angiotensin converting enzyme gene polymorphism and Indian army triathletes performance. Asian J Sports Med, 2010, 1(3):143-150.
22.	Ruiz JR, Gómez-Gallego F, Santiago C, et al. Is there an optimum endurance polygenic profile? J Physiol, 2009, 587(7):1527-1534.
23.	Scanavini D, Bernardi F, Castoldi E, et al. Increased frequency of the homozygous Ⅱ ACE genotype in Italian Olympic endurance athletes. Eur J Hum Genet, 2002, 10(10):576-577.
24.	Alvarez R, Terrados N, Ortolano R, et al. Genetic variation in the renin-angiotensin system and athletic performance. Eur J Appl Physiol, 2000, 82(1):117-120.
25.	Cieszczyk P, Krupecki K, Maciejewska A, et al. The angiotensin converting enzyme gene I/D polymorphism in Polish rowers. Int J Sports Med, 2009, 30(8):624-627.
26.	Lucia A, Gómez-Gallego F, Chicharro JL, et al. Is there an association between ACE and CKMM polymorphisms and cycling performance status during 3-week races? Intl J Sports Med, 2005, 26(6):442-447.
27.	Myerson S, Hemingway H, Budget R, et al. Human angiotensin I-converting enzyme gene and endurance performance. J Appl Phycol, 1999, 87(4):1313-1316.
28.	Nazarov IB, Woods DR, Montgomery HE, et al. The angiotensin converting enzyme I/D polymorphism in Russian athletes. Eur J Hum Genet, 2001, 9(10):797-801.
29.	Wang G, Mikami E, Chiu LL, et al. Association analysis of ACE and ACTN3 in elite Caucasian and East Asian swimmers. Med Sci Sports Exerc, 2013, 45(5):892-900.
30.	Juffer P, Furrer R, González-Freire M, et al. Genotype distributions in top-level soccer players:a role for ACE? Int J Sports Med, 2009, 30(5):387-392.
31.	Ginevičienė V, Pranculis A, Jakaitienė A, et al. Genetic variation of the human ACE and ACTN3 genes and their association with functional muscle properties in Lithuanian elite athletes. Medicina (Kaunas), 2011, 47(5):284-290.
32.	Ruiz JR, Arteta D, Buxens A, et al. Can we identify a power-oriented polygenic profile? J Appl Physiol, 2010, 108(3):561-566.
33.	Drozdovska SB, Dosenko VE, Ahmetov Ⅱ, et al. The association of gene polymorphisms with athlete status in Ukrainians. Biol Sport, 2013, 30(3):163-167.
34.	Muniesa CA, González-Freire M, Santiago C, et al. World-class performance in lightweight rowing:is it genetically influenced? A comparison with cyclists, runners and non-athletes. Br J Sports Med, 2010, 44(12):898-901.
35.	Grenda A, Leońska-Duniec A, Kaczmarczyk M, et al. Interaction between ACE I/D and ACTN3 R557X polymorphisms in Polish competitive swimmers. J Hum Kinet, 2014, 42(1):127-136.
36.	Taylor RR, Mamotte CD, Fallon K, et al. Elite athletes and the gene for angiotensin-converting enzyme. J Appl Physiol, 1999, 87(3):1035-1037.
37.	Rankinen T, Wolfarth B, Simoneau JA, et al. No association between the angiotensin-converting enzyme ID polymorphism and elite endurance athlete status. J Appl Physiol, 2000, 88:1571-1575.
38.	Hruskovicová H, Dzurenková D, Selingerová M, et al. The angiotensin converting enzyme I/D polymorphism in long distance runners. J Sports Med Phys Fitness, 2006, 46(3):509-513.
39.	Scott RA, Moran C, Wilson RH, et al. No association between angiotensin converting enzyme (ACE) gene variation and endurance athlete status in Kenyans. Comp Biochem Physiol A Mol Integr Physiol, 2005, 141(2):169-175.
40.	Ash GI, Scott RA, Deason M, et al. No Association between ACE Gene Variation and Endurance Athlete Status in Ethiopians. Med Sci Sports Exerc, 2011, 43(4):590-597.
41.	Collins M, Xenophontos SL, Carioliu MA, et al. The ACE Gene and Endurance Performance during the South African Ironman Triathlons. Med Sci Sports Exerc, 2004, 36(8):1314-1320.
42.	孙小敏, 甄文娟, 王煜, 等. 运动员血管紧张素转换酶基因插入或缺失多态性研究. 中国运动医学杂志, 2004, 23(5):546-547.
43.	李丽, 韩伟, 于英君. ACE基因I/D多态性与中国越野滑雪运动员运动能力的相关性研究. 冰雪运动, 2012, 34(1):54-58.
44.	席翼, 张秀丽, 胡扬, 等. 中国优秀马拉松运动员ACE基因I/D多态性频率分布特征. 中国运动医学杂志, 2006, 25(4):391-394.
45.	王国元, 何恩鹏, 阿布都克依木·热合曼. 新疆维吾尔族运动员ACE基因I/D多态与有氧运动能力关联研究. 西安体育学院学报, 2009, 26(2):214-218.
46.	于滢, 李云广. 我国优秀冬季项目运动员ACE基因I/D多态分布研究. 哈尔滨体育学院学报, 2013, 31(5):13-16.
47.	李丽, 毕鹏辉, 赵玉华, 等. 我国技能主导类优秀滑雪运动员ACE基因I/D多态性与运动能力的相关性分析. 南京体育学院学报(自然科学版), 2014, 13(5):18-21.
48.	高炳宏, 陈佩杰, 董强刚, 等. 上海地区汉族优秀游泳运动员ACE基因I/D多态性研究. 中国运动医学杂志, 2006, 25(5):517-521.
49.	Tobina T, Michishita R, Yamasawa F, et al. Association between the angiotensin I-converting enzyme gene insertion/deletion polymorphism and endurance running speed in Japanese runners. J Physiol Sci, 2010, 60(5):325-330.
50.	Puthucheary Z, Skipworth JR, Rawal J, et al. The ACE gene and human performance:12 years on. Sports Med, 2011, 41(6):433-448.
51.	Woods DR, Humphries SE, Montgomery HE. The ACE I/D Polymorphism and Human Physical Performance. Trends Endocrinol Metab, 2000, 11(10):416-420.
52.	Rankinen T, Roth SM, Bray MS, et al. Advances in exercise, fitness, and performance genomics. Med Sci Sports Exerc, 2010, 42(5):835-846.
53.	Moore TY, Biewener AA. Outrun or outmaneuver:predator-prey interactions as a model system for integrating biomechanical studies in a broader ecological and evolutionary context. Integr Comp Biol, 2015, 55(6):1188-1197.
54.	Hagberg JM, Moore GE, Ferrell RE. Specific genetic markers of endurance performance and V.O₂max. Exerc Sport Sci Rev, 2011, 29(1):15-19.

1. 邓文骞, 王璐, 左天香, 等. 耐力素质与力量素质相关基因的研究进展. 四川体育科学, 2007, 4(1):34-37.
2. 杨若愚, 王予彬, 沈勋章, 等. 基因多态性与杰出运动能力. 中国组织工程研究, 2014, 18(7):1121-1128.
3. Payne J, Montgomery H. Genetic variation and physical performance. World Rev Nutr Diet, 2004, 93:270-302.
4. 左彦方, 龙爱梅, 黄晓青, 等. 血管紧张素转换酶基因多态性与2型糖尿病肾病相关性的Meta分析. 中国循证医学杂志, 2012, 12(9):1071-1075.
5. 吴晓梅, 时玥, 时景璞. 中国汉族人群脑出血患者血管紧张素转换酶基因插入/缺失多态性的Meta分析. 中国循证医学杂志, 2009, 9(12):1323-1327.
6. Gayagay G, Yu B, Hambly B, et al. Elite endurance athletes and the ACE Ⅰ allele——the role of genes in athletic performance. Hum Genet, 1998, 103(1):48-50.
7. Hagberg J, Rankinen T, Loos R, et al. Advances in exercise, fitness, and performance genomics in 2010. Med Sci Sports Exer, 2011, 43(5):743-752.
8. Guth LM, Roth SM. Genetic influence on athletic performance. Curr Opin Pediatr, 2013, 25(6):653-658.
9. 杨贤罡, 扬胡. ACE基因I/D多态性与耐力素质的关联性研究:Meta分析. 体育科学, 2010, 30(7):42-49.
10. Ma F, Yang Y, Li X, et al. The association of sport performance with ACE and ACTN3 genetic polymorphisms:a systematic review and meta-analysis. PLoS One, 2013, 8(1):e54685.
11. 张明军, 叶学球. 中国汉族成年运动员ACE基因多态性与运动能力的Meta分析. 惠州学院学报, 2015, 35(3):109-116.
12. Moher D, Liberati A, Tetzlaff J, et al. Reprint——preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. Phys Ther, 2009, 89(9):873-880.
13. 曾宪涛, 高岭, 刘得玺, 等. 牙周病与口腔癌相关性的Meta分析. 湖北医药学院学报, 2012, 31(05):390-394.
14. Woods D, Hickman M, Jamshidi Y, et al. Elite swimmers and the D allele of the ACE I/D polymorphism. Hum Genet, 2001, 108(3):230-232.
15. Papadimitriou ID, Papadopoulos C, Kouvatsi A, et al. The ACE I/D polymorphism in elite Greek track and field athletes. J Sports Med Phys Fitness, 2009, 49(4):459-463.
16. Shahmoradi S, Ahmadalipour A, Salehi M. Evaluation of ACE gene I/D polymorphism in Iranian elite athletes. Adv Biomed Res, 2014, 3(1):207-213.
17. Costa A, Silva A, Garrido N, et al. Association between ACE D allele and elite short distance swimming. Eur J Appl Physiol, 2009, 106(6):785-790.
18. Amir O, Amir R, Yamin C, et al. The ACE deletion allele is associated with Israeli elite endurance athletes. Exp Physiol, 2007, 92(5):881-886.
19. Gómez-Gallego F, Santiago C, González-Freire G, et al. Endurance performance:genes or gene combinations? Int J Sports Med, 2008, 30(1):66-72.
20. Tanriverdi H, Evrengul H, Tanriverdi S, et al. Improved endothelium dependent vasodilation in endurance athletes and its relation with ACE I/D polymorphism. Circ J, 2005, 69(9):1105-1110.
21. Shenoy S, Tandon S, Sandhu J, et al. Association of angiotensin converting enzyme gene polymorphism and Indian army triathletes performance. Asian J Sports Med, 2010, 1(3):143-150.
22. Ruiz JR, Gómez-Gallego F, Santiago C, et al. Is there an optimum endurance polygenic profile? J Physiol, 2009, 587(7):1527-1534.
23. Scanavini D, Bernardi F, Castoldi E, et al. Increased frequency of the homozygous Ⅱ ACE genotype in Italian Olympic endurance athletes. Eur J Hum Genet, 2002, 10(10):576-577.
24. Alvarez R, Terrados N, Ortolano R, et al. Genetic variation in the renin-angiotensin system and athletic performance. Eur J Appl Physiol, 2000, 82(1):117-120.
25. Cieszczyk P, Krupecki K, Maciejewska A, et al. The angiotensin converting enzyme gene I/D polymorphism in Polish rowers. Int J Sports Med, 2009, 30(8):624-627.
26. Lucia A, Gómez-Gallego F, Chicharro JL, et al. Is there an association between ACE and CKMM polymorphisms and cycling performance status during 3-week races? Intl J Sports Med, 2005, 26(6):442-447.
27. Myerson S, Hemingway H, Budget R, et al. Human angiotensin I-converting enzyme gene and endurance performance. J Appl Phycol, 1999, 87(4):1313-1316.
28. Nazarov IB, Woods DR, Montgomery HE, et al. The angiotensin converting enzyme I/D polymorphism in Russian athletes. Eur J Hum Genet, 2001, 9(10):797-801.
29. Wang G, Mikami E, Chiu LL, et al. Association analysis of ACE and ACTN3 in elite Caucasian and East Asian swimmers. Med Sci Sports Exerc, 2013, 45(5):892-900.
30. Juffer P, Furrer R, González-Freire M, et al. Genotype distributions in top-level soccer players:a role for ACE? Int J Sports Med, 2009, 30(5):387-392.
31. Ginevičienė V, Pranculis A, Jakaitienė A, et al. Genetic variation of the human ACE and ACTN3 genes and their association with functional muscle properties in Lithuanian elite athletes. Medicina (Kaunas), 2011, 47(5):284-290.
32. Ruiz JR, Arteta D, Buxens A, et al. Can we identify a power-oriented polygenic profile? J Appl Physiol, 2010, 108(3):561-566.
33. Drozdovska SB, Dosenko VE, Ahmetov Ⅱ, et al. The association of gene polymorphisms with athlete status in Ukrainians. Biol Sport, 2013, 30(3):163-167.
34. Muniesa CA, González-Freire M, Santiago C, et al. World-class performance in lightweight rowing:is it genetically influenced? A comparison with cyclists, runners and non-athletes. Br J Sports Med, 2010, 44(12):898-901.
35. Grenda A, Leońska-Duniec A, Kaczmarczyk M, et al. Interaction between ACE I/D and ACTN3 R557X polymorphisms in Polish competitive swimmers. J Hum Kinet, 2014, 42(1):127-136.
36. Taylor RR, Mamotte CD, Fallon K, et al. Elite athletes and the gene for angiotensin-converting enzyme. J Appl Physiol, 1999, 87(3):1035-1037.
37. Rankinen T, Wolfarth B, Simoneau JA, et al. No association between the angiotensin-converting enzyme ID polymorphism and elite endurance athlete status. J Appl Physiol, 2000, 88:1571-1575.
38. Hruskovicová H, Dzurenková D, Selingerová M, et al. The angiotensin converting enzyme I/D polymorphism in long distance runners. J Sports Med Phys Fitness, 2006, 46(3):509-513.
39. Scott RA, Moran C, Wilson RH, et al. No association between angiotensin converting enzyme (ACE) gene variation and endurance athlete status in Kenyans. Comp Biochem Physiol A Mol Integr Physiol, 2005, 141(2):169-175.
40. Ash GI, Scott RA, Deason M, et al. No Association between ACE Gene Variation and Endurance Athlete Status in Ethiopians. Med Sci Sports Exerc, 2011, 43(4):590-597.
41. Collins M, Xenophontos SL, Carioliu MA, et al. The ACE Gene and Endurance Performance during the South African Ironman Triathlons. Med Sci Sports Exerc, 2004, 36(8):1314-1320.
42. 孙小敏, 甄文娟, 王煜, 等. 运动员血管紧张素转换酶基因插入或缺失多态性研究. 中国运动医学杂志, 2004, 23(5):546-547.
43. 李丽, 韩伟, 于英君. ACE基因I/D多态性与中国越野滑雪运动员运动能力的相关性研究. 冰雪运动, 2012, 34(1):54-58.
44. 席翼, 张秀丽, 胡扬, 等. 中国优秀马拉松运动员ACE基因I/D多态性频率分布特征. 中国运动医学杂志, 2006, 25(4):391-394.
45. 王国元, 何恩鹏, 阿布都克依木·热合曼. 新疆维吾尔族运动员ACE基因I/D多态与有氧运动能力关联研究. 西安体育学院学报, 2009, 26(2):214-218.
46. 于滢, 李云广. 我国优秀冬季项目运动员ACE基因I/D多态分布研究. 哈尔滨体育学院学报, 2013, 31(5):13-16.
47. 李丽, 毕鹏辉, 赵玉华, 等. 我国技能主导类优秀滑雪运动员ACE基因I/D多态性与运动能力的相关性分析. 南京体育学院学报(自然科学版), 2014, 13(5):18-21.
48. 高炳宏, 陈佩杰, 董强刚, 等. 上海地区汉族优秀游泳运动员ACE基因I/D多态性研究. 中国运动医学杂志, 2006, 25(5):517-521.
49. Tobina T, Michishita R, Yamasawa F, et al. Association between the angiotensin I-converting enzyme gene insertion/deletion polymorphism and endurance running speed in Japanese runners. J Physiol Sci, 2010, 60(5):325-330.
50. Puthucheary Z, Skipworth JR, Rawal J, et al. The ACE gene and human performance:12 years on. Sports Med, 2011, 41(6):433-448.
51. Woods DR, Humphries SE, Montgomery HE. The ACE I/D Polymorphism and Human Physical Performance. Trends Endocrinol Metab, 2000, 11(10):416-420.
52. Rankinen T, Roth SM, Bray MS, et al. Advances in exercise, fitness, and performance genomics. Med Sci Sports Exerc, 2010, 42(5):835-846.
53. Moore TY, Biewener AA. Outrun or outmaneuver:predator-prey interactions as a model system for integrating biomechanical studies in a broader ecological and evolutionary context. Integr Comp Biol, 2015, 55(6):1188-1197.
54. Hagberg JM, Moore GE, Ferrell RE. Specific genetic markers of endurance performance and V.O₂max. Exerc Sport Sci Rev, 2011, 29(1):15-19.

Chinese Journal of Evidence-Based Medicine

Association between the Insertion/Deletion Polymorphism of ACE Gene and Athlete's Sport Performance in Endurance Sports: A Meta-analysis

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