Key result
The ACE gene II genotype was not significantly associated with the risk of diabetic retinopathy in type 2 diabetes patients compared to ID+DD genotypes (OR 1.12; 95% CI 0.96-1.31; p=0.1359).
Why the study?
The ACE gene is possibly involved in diabetic retinopathy development, but the relationship between the ACE gene I/D polymorphism and diabetic retinopathy in type 2 diabetic patients required elucidation.
Does the ACE gene (I/D) polymorphism associate with the development and progression of diabetic retinopathy in type 2 diabetic patients?
Meta-Analysis
Does the ACE gene (I/D) polymorphism associate with the development and progression of diabetic retinopathy in type 2 diabetic patients?
Odds Ratio: 1.12 (95% CI 0.96–1.31)
p-value: p=0.1359
The ACE I/D gene polymorphism does not appear to be associated with the susceptibility to or progression of diabetic retinopathy in patients with type 2 diabetes.
No support for ACE I/D testing in DR risk stratification; leaves open other genetic contributors in type 2 diabetes.
Diabetic retinopathy (DR) is a complex and multifactorial pathology encompassing environmental, metabolic, and polygenic influences. Among the genes possibly involved in the development and progression of DR, the Angiotensin I-converting enzyme (ACE) gene stands out, which presents an insertion (I) or deletion (D) polymorphism of a 287 bp Alu repetitive sequence in intron 16. Thus, this study aimed to perform a systematic review with meta-analysis to elucidate the relationship between the ACE gene (I/D) polymorphism (rs1799752) and the development and progression of DR in type 2 diabetic patients. PubMed/MEDLINE, Embase, Web of Science, and Scopus databases were systematically searched to retrieve articles that investigated the association between ACE gene (I/D) polymorphism in DR patients. Sixteen articles were included in the systematic review. The results describe no significant association between the polymorphism and DR risk (OR = 1.12; CI = 0.96–1.31; and p = 0.1359) for genotypic analysis by the dominant model (II vs. ID+DD). Moreover, we also observed no significant association between the D allele on the allele frequency analysis (I vs. D) and the DR risk (OR = 1.10; CI = 0.98–1.23; and p = 0.1182). Forest plot analysis revealed that the discrepancy between previous studies most likely arose from variations in their sample sizes. In conclusion, I/D polymorphism appears to be not involved in the susceptibility to and progression of the DR in type 2 diabetic patients.
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Coelho et al. (2023) conducted a meta-analysis in Diabetic retinopathy in type 2 diabetes mellitus. ACE gene II genotype vs. ID+DD genotype was evaluated on Diabetic retinopathy risk (OR 1.12, 95% CI 0.96-1.31, p=0.1359). The ACE gene II genotype was not significantly associated with the risk of diabetic retinopathy in type 2 diabetes patients compared to ID+DD genotypes (OR 1.12; 95% CI 0.96-1.31; p=0.1359).
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