The impact of angiotensin converting enzyme insertion/deletion gene polymorphism on diabetic kidney disease: A debatable issue

The objective of this study was to evaluate the influence of ACE I/D gene polymorphisms on diabetic kidney disease (DKD) risk. All eligible investigations were identified, the number of various genotype in the case and control group were reviewed. The pooled analysis was performed using Stata software. In overall subjects, 24,321 participants with 12,961 cases and 11,360 controls were included. the pooled analysis showed a significant link between D allele, DD or II genotype and DKD risk (D versus I: OR=1.316, 95% CI: 1.213–1.427, P=0.000; DD versus ID+II: OR=1.414, 95% CI: 1.253–1.595, P=0.000; II versus DD+ID: OR=0.750, 95% CI: 0.647–0.869, P=0.000). The subgroup pooled analysis showed that ACE I/D gene polymorphism was correlated with DKD both in Asian and in Chinese population. In addition, ACE I/D gene polymorphism was correlated with type 2 DKD (D versus I: OR=1.361, 95% CI: 1.243–1.490, P=0.000; DD versus ID+II: OR=1.503, 95% CI: 1.310–1.726, P=0.000; II versus DD+ID: OR=0.738, 95% CI: 0.626 –0.870, P=0.000). However, there was no obvious correlation in Caucasian subjects and type 1 diabetic patients. ACE I/D polymorphisms were correlated with DKD in Asian and type 2 diabetic populations. ACE D allele/DD genotype might be a risk factor, while ACE II genotype might be a protective factor for DKD. El objetivo de este estudio fue evaluar la influencia de los polimorfismos del gen I/D de la ECA en el riesgo de enfermedad renal diabética (ERD). Se identificaron todas las investigaciones elegibles, se revisó el número de varios genotipos en el grupo de casos y controles. El análisis combinado se realizó con el software Stata. En el conjunto de los sujetos, se incluyeron 24.321 participantes con 12.961 casos y 11.360 controles. El análisis combinado mostró una relación significativa entre el alelo D, el genotipo DD o II y el riesgo de DKD (D frente a I: OR=1,316, IC del 95%: 1,213–1,427, P=0,000; DD frente a ID+II: OR=1,414, IC del 95%: 1,253-1,595, P=0,000; II frente a DD+ID: OR=0,750, 95% CI: 0,647-0,869, P=0,000). El análisis de subgrupos mostró que el polimorfismo del gen I/D de la ECA se correlacionaba con la DMD tanto en la población asiática como en la china. Además, el polimorfismo del gen I/D de la ECA se correlacionó con la DKD de tipo 2 (D frente a I: OR=1,361, IC del 95%: 1,243-1,490, P=0,000; DD frente a ID+II: OR=1,503, IC del 95%: 1,310-1,726, P=0,000; II frente a DD+ID: OR=0,738, 95% CI: 0,626 -0,870, P=0,000). Sin embargo, no hubo una corr