title: Relationship between angiotensin-converting enzyme insertion/deletion gene polymorphism and systemic lupus erythematosus/lupus nephritis: a systematic review and metaanalysis.
abstract: OBJECTIVE
  Results from studies of the association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and systemic lupus erythematosus (SLE)/lupus nephritis (LN) are controversial. We performed this metaanalysis to evaluate the relationship between ACE I/D gene polymorphism and SLE/LN and to explore whether the ACE D allele or DD genotype could become a predictive marker for risk of SLE/LN.
  
  
  METHODS
  Association studies were identified from the databases of PubMed, Embase, Cochrane Library and CBM-disc (China Biological Medicine Database) as of May 1, 2011, and eligible investigations were synthesized using a metaanalysis method. Results were expressed with OR for dichotomous data, and 95% CI were calculated.
  
  
  RESULTS
  Sixteen investigations were identified for the analysis of association between ACE I/D gene polymorphism and SLE, consisting of 1959 patients with SLE and 2078 controls. In the overall populations, there was a marked association between D allele or DD genotype and SLE susceptibility (D: OR 1.29, 95% CI 1.04-1.58, p = 0.02; DD: OR 1.60, 95% CI 1.17-2.19, p = 0.003), and DD homozygous was associated with LN risk (OR 2.78, 95% CI 1.26-6.11, p = 0.01). In the subgroup analysis, DD genotype associated with SLE risk was observed in Asians; no other association was found in Asians, whites, Africans, and Brazilians.
  
  
  CONCLUSIONS
  D allele and DD homozygous are significant genetic molecular markers to predict SLE susceptibility, and DD genotype is a valuable marker to predict the LN risk. More investigations are required to clarify the association of the D allele or DD homozygous with SLE/LN susceptibility.
authors.affiliation: Department of Pediatrics, The First Affiliated Hospital of GuangXi Medical University, NanNing 530021, China.
authors.forename: Tian-Biao
authors.initials: TB
authors.lastname: Zhou
authors.forename: Yun-Guang
authors.initials: YG
authors.lastname: Liu
authors.forename: Na
authors.initials: N
authors.lastname: Lin
authors.forename: Yuan-Han
authors.initials: YH
authors.lastname: Qin
authors.forename: Ken
authors.initials: K
authors.lastname: Huang
authors.forename: Ming-Bin
authors.initials: MB
authors.lastname: Shao
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Peng
mesh_terms: D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D054643:INDEL Mutation / Q000235:genetics*; D008180:Lupus Erythematosus, Systemic / Q000201:enzymology / Q000453:epidemiology* / Q000235:genetics*; D008181:Lupus Nephritis / Q000201:enzymology / Q000453:epidemiology* / Q000235:genetics*; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics; D012307:Risk Factors
chemical_list: C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A