Highlights
- •We report the current totality of evidence on ACE I/D polymorphism and IS risk.
- •ACE I/D polymorphism is confirmed as a risk factor for IS.
- •This study may enrich studies on the identification of genetic variations of IS risk.
- •This study may aid to find the theory for risk prediction, prevention, and therapy.
Abstract
Background
The association between the angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism and risk of ischemic stroke (IS) remains controversial and ambiguous.
To clarify this association, a large meta-analysis was performed.
Methods
Electronic databases in both English and Chinese were used to identify relevant studies
(updated in February 2014). Odds ratios (ORs) and 95% confidence intervals (95% CIs)
were used to describe the strength of the association.
Results
One hundred and fifty eligible studies, including 18,258 IS cases and 28,768 controls,
were identified. Meta-analysis of these studies pointed to a significant association
between the ACE I/D polymorphism and IS risk: (D vs. I: OR = 1.354, 95% CI = 1.272–1.440, P < 0.001; DD vs. II: OR = 1.755, 95% CI = 1.561–1.973, P < 0.001; ID vs. II: OR = 1.178, 95% CI = 1.098–1.263, P < 0.001; DD vs. ID/II: OR = 1.535, 95% CI = 1.399–1.684, P < 0.001; DD/ID vs. II: OR = 1.353, 95% CI = 1.251–1.463, P < 0.001). Subgroup analysis revealed a significantly elevated risk among Asians, but
with borderline statistical significance among Caucasians.
Conclusion
This meta-analysis indicated that the ACE I/D polymorphism may be a genetic susceptibility factor for IS, especially among
Asians, but with borderline statistical significance for Caucasians. Further investigations
are needed to validate our conclusions.
Keywords
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Article info
Publication history
Published online: July 17, 2014
Accepted:
July 10,
2014
Received in revised form:
July 6,
2014
Received:
April 23,
2014
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
