Original Article Association between the insertion/deletion polymorphism of angiotensin converting enzyme gene and rheumatic heart disease: a comprehensive meta-analysis
Int J Clin Exp Med
Objective: Previous reports on the association between the insertion/deletion (I/D) polymorphism of an-giotensin converting enzyme (ACE) gene and rheumatic heart disease (RHD), remained conflicting. This study was to further evaluate the association between ACE I/D polymorphism and RHD risk. Methods: Databases including PubMed, EMbase, CNKI and WanFang were retrieved to collect the related case-control studies. After screening studies and extracting data by 2 researchers independently, a
... pendently, a meta-analysis was performed by Stata 12.0. Results: A total of 6 articles including 981 RHD patients and 901 controls were included. We found that there was a significant decreased susceptibility to RHD in a heterozygous model (OR=0.76, 95% CI: 0.58-0.99, P=0.040). Further subgroup analysis by age showed that the ACE I/D polymorphism in younger patients, but not in older patients, was significantly associated with RHD (allele model: OR=0.69, 95% CI: 0.52-0.91, P=0.010; homozygous model: OR=0.37, 95% CI: 0.19-0.71, P=0.003; recessive model: OR=0.64, 95% CI: 0.42-0.97, P=0.040). Moreover, there was a direct association between the ACE I/D polymorphism and the risk of mitral valve lesion (MVL) (allele model: OR=0.62, 95% CI: 0.43-0.89, P=0.009; homozygous model: OR=0.27, 95% CI: 0.11-0.64, P=0.003; recessive model: OR=0.57, 95% CI: 0.34-0.95, P=0.030) or combined valve lesion (CVL) (homozygous model: OR=0.47, 95% CI: 0.22-0.99, P=0.048) in younger patients. Conclusion: Taken together, these results suggest that the ACE I/D polymorphism is significantly associated with RHD, and DD genotype increases the risk of RHD.