血管紧张素I转换酶基因插入/缺失遗传变异与中国人群2型糖尿病肾病发病风险的Meta分析

Meta-analysis of insertion/deletion genetic variation of ACE gene and onset risk of type 2 diabetic nephropathy in Chinese population

目的综合评估血管紧张素I转换酶(ACE)插入/缺失(I/D)遗传变异与中国人群2型糖尿病肾病(T2DN)发病风险的关系。方法应用中国知网(CNKI)及万方数据知识服务平台检索相关文献,截止日期2016年6月1日。运用Review Manager 5.0研究数据进行统计分析,以合并OR值及相应95%置信区间(95%CI)评估ACE基因I/D多态与T2DN的发病风险。结果依据纳入、排除标准,共29篇文献4 357例研究对象,包括2 208例T2DN患者和2 149例2型糖尿病且无DN者纳入本研究。Meta分析显示,与ACE基因I/D多态I等位基因相比,D等位基因可显著增加T2DM患者发生DN的风险,OR值及相应95%CI为1.44(1.25,1.66);基因型分析显示,在显性和隐性遗传模型下,ACE基因I/D多态位点与中国人群DN发病风险显著相关,相对发病风险的OR及相应95%CI为1.42(1.15,1.76)和1.75(1.46,2.10)。Begg′s检验显示,所纳入研究数据不存在明显发表偏倚。结论 ACE基因I/D多态性与T2DN发病风险密切相关,D等位基因可能是2型糖尿病患者发生DN的危险遗传因素。

Objective To systematically assess the relation between angiotensin-I converting enzyme（ACE）gene insertion/deletion（I/D）variation and type 2diabetic nephropathy（T2DN）onset risk among Chinese population.Methods The related literatures were retrieved from the China National Knowledge Infrastructure（CNKI）and Wanfang Data until June 1st,2016.The RevMan 5.0was used to conduct the statistical analysis.The merge OR value and corresponding 95% confidence interval（95%CI）were used to assess ACE gene I/D polymorphism and T2DN onset risk.Results Totally 29 papers with 4 357 subjects were included according to the inclusion and exclusion standard,including 2 208 cases of DN and 2 149 cases of T2DM without DN.Meta analysis showed that compared with ACE gene I/D polymorphism I allele,D allele could significantly increase the risk of T2DM patients suffering from DN,the ORvalue and corresponding 95%CI were 1.44（1.25,1.66）;the gene analysis showed that ACE gene I/D polymorphism loci were significantly correlated with DN onset risk in the Asian population.The corresponding relative onset risk ORand 95%CI were 1.42（1.15,1.76）and 1.75（1.46,2.10）in the dominant and recessive genetic model.The Begg′s test showed that the included data had no obvious publication bias existence.Conclusion ACE gene I/D polymorphism is closely correlated with the onset risk of T2 DN,and D allele might be a risk genetic factor for DN occurrence in the patients with T2DM.