%0 Journal Article
%T Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism Contributes High Risk for Chronic Kidney Disease in Asian Male with Hypertension每A Meta-Regression Analysis of 98 Observational Studies
%A Chin Lin
%A Hsin-Yi Yang
%A Chia-Chao Wu
%A Herng-Sheng Lee
%A Yuh-Feng Lin
%A Kuo-Cheng Lu
%A Chi-Ming Chu
%A Fu-Huang Lin
%A Sen-Yeong Kao
%A Sui-Lung Su
%J PLOS ONE
%D 2014
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0087604
%X Background Associations between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and chronic kidney disease (CKD) have been extensively studied, with most studies reporting that individuals with the D allele have a higher risk. Although some factors, such as ethnicity, may moderate the association between ACE I/D polymorphisms and CKD risk, gender-dependent effects on the CKD risk remain controversial. Objectives This study investigated the gender-dependent effects of ACE I/D polymorphisms on CKD risk. Data sources PubMed, the Cochrane library, and EMBASE were searched for studies published before January 2013. Study eligibility criteria, participants, and interventions Cross-sectional surveys and case每control studies analyzing ACE I/D polymorphisms and CKD were included. They were required to match the following criteria: age >18 years, absence of rare diseases, and Asian or Caucasian ethnicity. Study appraisal and synthesis methods The effect of carrying the D allele on CKD risk was assessed by meta-analysis and meta-regression using random-effects models. Results Ethnicity [odds ratio (OR): 1.24; 95% confidence interval (CI): 1.08每1.42] and hypertension (OR: 1.55; 95% CI: 1.04每2.32) had significant moderate effects on the association between ACE I/D polymorphisms and CKD risk, but they were not significant in the diabetic nephropathy subgroup. Males had higher OR for the association between ACE I/D polymorphisms and CKD risk than females in Asians but not Caucasians, regardless of adjustment for hypertension (p<0.05). In subgroup analyses, this result was significant in the nondiabetic nephropathy group. Compared with the I allele, the D allele had the highest risk (OR: 3.75; 95% CI: 1.84每7.65) for CKD in hypertensive Asian males. Conclusions and implications of key findings The ACE I/D polymorphisms may incur the highest risk for increasing CKD in hypertensive Asian males.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0087604