Meta analysis of  angiotensin-converting enzyme I/D polymorphism as a risk factor for  preeclampsia in Chinese women.
Preeclampsia affects 3-8% of pregnancies and is a  major cause of maternal and perinatal morbidity and mortality worldwide.  Inappropriate activation of the renin-angiotensin system may play a role in the  development of preeclampsia. An insertion/deletion polymorphism in the  angiotensin-converting enzyme gene (ACE-I/D) has been associated with  differences in ACE activity. However, there are controversies in reports on the  association of ACE-I/D with preeclampsia. Data were analyzed using Review  Manager Version 5.0 and a random effects model was applied irrespective of  between studies heterogeneity, which was evaluated via sensitivity and subgroup  analyses. Publication bias was evaluated using the fail-safe number. A  systematic search was performed based on published case control studies up to  October 1, 2011, and 11 studies were included, involving 800 patients and 949  controls. Significant association of the ACE D allele with increase risk  of preeclampsia was found (odds ratio = 1.93, 95% confidence interval =  1.19-3.12; P = 0.008). Sensitivity analysis showed that no individual study had  an undue influence on the summary odds ratios for all contrasts. An analysis  stratified by study size showed an attenuated odds ratio towards a null effect  as study size increased. Based on our meta-analysis, we suggest that the D  allele of the ACE gene is related with increased risk for preeclampsia  in the Chinese population. Considering the potential existence of small study  bias, further research should be performed with a larger dataset.
Shanghai Putuo Maternity and Infant Health Hospital, Shanghai, China. zhong_weiguo@sina.com
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D000328:Adult; D000483:Alleles; D044466:Asian People / Q000235:genetics*; D002681:China; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D054643:INDEL Mutation / Q000235:genetics*; D016017:Odds Ratio; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011225:Pre-Eclampsia / Q000201:enzymology* / Q000235:genetics*; D011247:Pregnancy; D017594:Publication Bias; D012307:Risk Factors
C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A