Key result
ACE I/D polymorphism lacks overall link to VUR or renal scars except in Turkish children.
Why the study?
Previous studies investigating the association between ACE I/D gene polymorphism and vesicoureteral reflux susceptibility in children have yielded conflicting results.
Is the ACE I/D gene polymorphism associated with vesicoureteral reflux susceptibility in children?
Meta-Analysis
Is the ACE I/D gene polymorphism associated with vesicoureteral reflux susceptibility in children?
The ACE I/D gene polymorphism does not appear to be broadly associated with vesicoureteral reflux susceptibility in children, except potentially in specific populations like Turkish children.
No role for ACE I/D testing in VUR risk assessment; leaves open ethnic-specific effects for validation.
BACKGROUND AND OBJECTIVE: Many studies have been conducted to investigate the association between angiotensin-converting enzyme (ACE) insertion (I)/deletion (D) gene polymorphism and vesicoureteral reflux (VUR) susceptibility. However, the results from those studies are still conflicting. We performed a meta-analysis of studies relating the ACE I/D gene polymorphism to the risk of VUR. METHOD: We searched the databases of PubMed, Embase, Cochrane Library and CBM-disc (China Biological Medicine Database) as of 1 March 2011, and recruited the eligible investigations for this meta-analysis. RESULTS: Ten investigations were identified for the analysis of association between ACE I/D gene polymorphism and VUR risk: six in Caucasians, three in East-Asians and one in a Turkish population. All the investigations were performed in children. There was no marked association between ACE I/D gene polymorphism and VUR susceptibility/renal scar for overall populations, Caucasians and East-Asians. In the Turkish population, D allele and DD genotype were associated with the VUR susceptibility/renal scar. Furthermore, ACE I/D gene polymorphism was not associated with VUR progression. CONCLUSIONS: D allele and DD genotype are risk factors for the VUR susceptibility/renal scar in Turkish children. However, more case-control association investigations on larger, stratified populations are required in the future.
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Zhou et al. (2012) conducted a meta-analysis in Vesicoureteral reflux (VUR) susceptibility. ACE I/D gene polymorphism vs. Other ACE genotypes was evaluated on VUR susceptibility and renal scar. ACE I/D gene polymorphism was not associated with VUR susceptibility or renal scar overall, but the D allele and DD genotype were risk factors in Turkish children.
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