中国居民血管紧张素转换酶基因多态性与冠心病易感性关系的荟萃分析

目的综合评价血管紧张素转换酶（ACE）基因插入和（或）缺失（insertion／deletion,I／D）多态性与冠心病易感性的关系。方法用关键词途径搜索了Medline光盘数据库（1994年1月至2005年2月）和中国医院知识仓库（CHKD）中文期刊全文库（1994年1月至2005年5月）,搜集所有研究ACE基因多态性与冠心病易感关系的病例对照研究,应用RevMan 4．2软件对各研究结果进行异质性检验和数据合并。结果共有16篇符合条件的文献纳入分析,累积病例1345例,累积对照1286例。同杂合子（DI）和（或）纯合子插入型（Ⅱ）基因型相比,DD（纯合子缺失型）基因型冠心病的发病风险高出156％（OR=2．56,95％CI为2．09～3．13）;ACE D等位基因与冠心病关系的趋势性检验结果表明,随着D等位基因的增多发生冠心病的危险性也随之增大（xTrend^2=97．12,P〈0．01）。结论ACE基因多态性可能与我国人群冠心病的易感性相关,DD基因型个体冠心病的发病风险明显增高,冠心病发病风险与D等位基因密切相关。

Meta-analysis of association of deletion allele of angiotensin-converting enzyme gene with coronary heart disease in China

OBJECTIVE: To qualitatively and quantitatively assess the evidence regarding the relation of ACE I/D polymorphism to coronary heart disease (CHD) risk. METHODS: Medline (January 1994 to February 2005) and China Hospital Knowledge Databases (January 1994 to May 2005) were retrieved for all publications relating to case-control studies reporting a link between CHD risk factors and the ACE I/D polymorphism. All 16 association studies were identified and a meta-analysis was conducted by using the RevMan 4.2 estimate for odds ratio (OR) to determine whether the DD genotype might predict the outcome in CHD. RESULTS: Sixteen out of 48 identified studies reporting data on 1345 CHD patients and 1286 matched controls fulfilled these inclusion criteria. The overall distribution of genotypes in the control subjects was 35.88% II, 40.86% ID, and 23.26% DD. The odds ratio for CHD for DD versus ID/II genotypes across all studies was 2.56 95% CI, 2.09 - 3.13]. The relative CHD risk appeared to be increased with the D allele (chi(Trend)(2) = 97.12, P < 0.01). CONCLUSIONS: ACE gene I/D polymorphism should be associated with susceptivity of coronary heart disease in China. The CHD risk is increased significantly in individuals with DD genotypes. The ACE D allele should be a risk factor for CHD.