Key result
The ACE D allele and DD genotype were significantly associated with increased risk of IgA nephropathy in Asians (D allele OR 1.27, p=0.006), but not in Caucasians or with disease progression.
Why the study?
Does the ACE gene D allele or DD genotype increase the risk or progression of IgA nephropathy in different ethnic groups?
Meta-Analysis
Does the ACE gene D allele or DD genotype increase the risk or progression of IgA nephropathy in different ethnic groups?
Odds Ratio: 1.27
p-value: p=0.006
The ACE D allele or DD genotype is associated with an increased risk of IgA nephropathy in Asian populations, but not in Caucasians, and is not associated with disease progression in either group.
May inform ethnic-specific risk stratification in Asian IgA nephropathy; confirms associations but leaves progression and causality open.
BACKGROUND: and objective: The effect of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism on risk or progression of immunoglobulin A nephropathy (IgAN) is still debated.Therefore, a meta-analysis was performed to evaluate the association of ACE gene polymorphism with IgAN in different ethnic groups. METHOD: A predefined search strategy was performed to collect data from electronic databases. RESULTS: Twenty articles were identified for the analysis of the relationship between ACE polymorphism and IgAN risk, including 11 in Asians and nine in Caucasians. There was a markedly positive association between the D allele or DD genotype and IgAN risk in Asians (OR = 1.27, p = 0.006; OR = 1.83, p < 0.0001). However, a link between D allele or DD genotype and IgAN risk was not found in Caucasians (OR = 1.04, p = 0.46; OR = 1.13, p = 0.12). Ten investigations were included for analysis of the association of ACE polymorphism with IgAN progression, including six in Asians and four in Caucasians. These data did not support a link between the ACE D allele or DD genotype and IgAN progression in Asians and Caucasians (Asians: D: OR = 1.03, p = 0.80; DD: OR = 1.43, p = 0.16; Caucasians: D: OR = 1.29, p = 0.22; DD: OR = 1.31, p = 0.17). CONCLUSIONS: The D allele or DD genotype is associated with IgAN risk in Asian, but not in Caucasian populations; there was no significant association between the D allele or DD gene and IgAN progression for Asians and Caucasians.
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Qin et al. (2011) conducted a meta-analysis in Immunoglobulin A nephropathy (IgAN). ACE gene D allele or DD genotype vs. Other ACE genotypes was evaluated on IgAN risk in Asians (D allele) (OR 1.27, p=0.006). The ACE D allele and DD genotype were significantly associated with increased risk of IgA nephropathy in Asians (D allele OR 1.27, p=0.006), but not in Caucasians or with disease progression.