ACE 基因多态性与儿童过敏性紫癜及紫癜性肾炎遗传易感性关系的荟萃分析

Meta-analysis of the association between angiotension-converting enzyme I/D polymorphism and susceptibility to children with Henoch-Sch？nlein purpura or Henoch-Sch？lein purpura nephritis

目的：探讨血管紧张素转换酶（ ACE ）基因多态性与儿童过敏性紫癜（ HSP ）及紫癜性肾炎（ HSPN）的关联性。方法计算机检索PubMed、Embase、Google Scholar、Pringer Link、Highwire、Cochrane、ISI和中国知网（ CNKI）、万方和维普等中国学术期刊全文数据库网，检索从建库至2013年12月31日公开发表的关于ACE基因多态性与儿童HSP及HSPN遗传易感性关系的病例-对照研究的文献。按照纳入标准选择文献，提取相关数据，对纳入文献进行异质性检验，应用Stata 12.0软件计算合并效应量OR值及95％CI以进行荟萃分析。结果共纳入11篇文献。其中5篇文献涉及ACE I/D基因多态性与HSP易感性相关性研究，共累积病例512例，对照631例；遗传模型荟萃分析结果显示：ACE I/D基因多态性与HSP易感性的关联性有统计学意义（ D等位基因/I等位基因：OR＝1.23，95％CI：1.04～1.46，P＜0.05；DD/DI＋II基因型：OR＝1.24，95％CI：0.77～2.00，P＞0.05；II/DD＋DI基因型：OR＝0.68，95％CI：0.52～0.90，P＜0.05）。9篇文献涉及ACE I/D基因多态性与HSPN易感性相关性研究，共累积病例446例，对照877例，遗传模型荟萃分析结果显示：ACE I/D基因多态性与HSPN 易感性的关联性有统计学意义（ D等位基因/I 等位基因：OR＝1.52，95％CI：1.14～2.04，P＜0.05；DD/DI＋II基因型：OR＝1.85，95％CI：1.06～3.21，P＜0.05；II/DD＋DI基因型：OR＝0.62，95％CI：0.47～0.82，P＜0.05）。结论不同种族人群中ACE I/D基因多态性中的DD基因型可提高儿童HSP/HSPN遗传易感性，很可能为儿童HSP及HSPN的危险基因型，而II基因型能够降低儿童HSP/HSPN遗传易感性，很可能为儿童HSP及HSPN的保护基因型。

Objective To explore the relationship between angiotension-converting enzyme （ ACE） I/D polymorphism and susceptibility to Henoch-Sch？nlein purpura or Henoch-Sch？nlein purpura nephritis （HSP/HSPN） especially among Chinese children.Methods The publications up to December 31,2013 from PubMed,Embase,Google Scholar,Springer Link,Highwire,Cochrane,ISI,CNKI and Wanfang databases were searched for relevant literature on the association between ACE I /D polymorphism and pediatric HSP/HSPN.Heterogeneity was evaluated.And Stata 12.0 was used to assess the association strength in terms of odds ratio （ OR） and 95%CI.Results A total of 11 case-control studies fulfilled the inclusion criteria.And 5 articles were indentified for analyzing the relationship between ACE I /D polymorphism and pediatric HSP risk,involving 512 cases and 631 controls.Significantly risks of HSP were found （D/I：OR（95%CI）=1.23 （1.04-1.46）,P〈0.05; DD/DI＋II：OR（95%CI） =1.24（0.77 -2.00）,P〉0.05 and II/DD＋DI：0.68（0.52-0.90）,P〈0.05）.Nine articles were indentified for analyzing the relationship between ACE I /D polymorphism and pediatric HSPN risk ,involving 446 cases and 877 controls.Significant risks of pediatricHSPN were found （D/I：OR （95%CI） =1.52（1.14-2.04）,P〈0.05; DD/DI＋II： OR（95%CI） =1.85（1.06-3.21）,P〈0.05;II/DD＋DI：OR（95%CI）=0.62（0.47-0.82）,P〈0.05）.Conclusions In different ethnic groups ,genotype DD of ACE I/D may increase the risk of pediatric HSP/HSPN and thus constitute a risk factor.Genotype II of ACE I/D may decrease the risks of pediatric HSP/HSPN and it may be a constitutively protective factor for pediatric HSP/HSPN.