Meta analysis of angiotensin-converting enzyme I/D polymorphism as a risk factor for preeclampsia in Chinese women

Abstract

ABSTRACT. Preeclampsia affects 3-8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality worldwide. Inappropriate activation of the renin-angiotensin system may play a role in the development of preeclampsia. An insertion/ deletion polymorphism in the angiotensin-converting enzyme gene (ACE-I/D) has been associated with differences in ACE activity. However, there are controversies in reports on the association of ACE-I/D with preeclampsia. Data were analyzed using Review Manager Version 5.0 and a random effects model was applied irrespective of between studies heterogeneity, which was evaluated via sensitivity and subgroup analyses. Publication bias was evaluated using the fail-safe number. A systematic search was performed based on published case control studies up to October 1, 2011, and 11 studies were included, involving 800 patients and 949 controls. Significant association of the ACE D allele with increase risk of preeclampsia was found (odds ratio = 1.93, 95% confidence interval = 1.19-3.12; P = 0.008). Sensitivity analysis showed that no individual study had an undue influence on the ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 11 (3): 2268-2276 (2012) Angiotensin-converting enzyme polymorphism and preeclampsia 2269 summary odds ratios for all contrasts. An analysis stratified by study size showed an attenuated odds ratio towards a null effect as study size increased. Based on our meta-analysis, we suggest that the D allele of the ACE gene is related with increased risk for preeclampsia in the Chinese population. Considering the potential existence of small study bias, further research should be performed with a larger dataset.

Vitamin D receptor FokI gene polymorphism and tuberculosis susceptibility: a meta-analysis

“…I 2 values of 25, 50, and 75% were defined as low, moderate, and high estimates, respectively. When I 2 > 50%, heterogeneity was indicated across studies and the random-effect model was used for meta-analysis; otherwise, the fixed-effect model was used (Zhou et al, 2011;Zhong et al, 2012). Stratified analysis was performed according to ethnicity.…”

The insertion-deletion polymorphism of the ACE gene is associated with increased blood pressure in women at the end of pregnancy

“…35,[37][38][39] A large study (more than 1000 Caucasian women) conducted by Pfab with coworkers did not reveal the association of I/D polymorphism of the ACE gene with BP level during a pregnancy. 40 Meantime, a meta-analysis of more than 50 studies showed a significant association of the I/D polymorphism with PIH and preeclampsia in Chinese, 41,42 and in Asians and Caucasians. 43 The observed inconsistency in the above results may be explained by inter-population and interethnic differences in the distribution of the I/D polymorphism: allele D is predominant in Caucasians from Europe, Australia and the USA, whereas allele I is more prevalent among Chinese and Indians.…”

Angiotensin Converting Enzyme 90kDa isoform: Biomarker for diagnosis of preeclampsia?

“…Meanwhile, the findings related to the genetic polymorphism of ACE in PE results in different data. Perhaps this contradiction is based on the analysis of distinct populations, with them having differing ethnic and genetic characteristics [28][29][30][31][32].…”

“…Studies on the genetic polymorphism of the angiotensin-converting enzyme (ACE), one of the components of the RAS, demonstrate that the D allele is related to elevated plasma ACE levels, and is strongly associated with cardiovascular diseases [27]. However, the findings concerning ACE genetic polymorphism in PE are contradictory [28][29][30][31][32].…”