title: Association of angiotensin-converting enzyme insertion/deletion polymorphism (rs4646994) with the risk of primary intracerebral hemorrhage.
abstract: BACKGROUND
  Evidence has suggested that angiotensin-converting enzyme (ACE) may be involved in the etiology of primary intracerebral hemorrhage (PICH), but the underlying association between ACE I/D (rs4646994) polymorphism and PICH risk is still ambiguous. This meta-analysis was performed to quantitatively summarize the evidence for such a relationship.
  
  
  METHODS
  Eligible studies were identified by searching PubMed, EMBASE, CNKI (China National Knowledge Infrastructure), CBM (Chinese biomedical literature database), and WANFANG databases within a range of published years from 1990 to August 2012. The odds ratio (OR) corresponding to the 95% confidence interval (CI) was used to assess the different associations.
  
  
  RESULTS
  A total of 28 studies with 2806 cases and 3612 controls were included in this meta-analysis. The pooled examination displayed an overall increased PICH risk associated with ACE I/D polymorphism in a recessive model (OR = 1.80, 95% CI = 1.39-2.33, P < 0.001 for DD versus ID/II), however, this association was only present in Asians (OR = 1.91, 95% CI = 1.45-2.51, P < 0.001) and not in Caucasians (OR = 1.16, 95% CI = 0.55-2.44, P = 0.69). Hypertensive intracerebral hemorrhage (HICH) had a much greater risk (OR = 4.26, 95% CI = 2.87-6.32, P < 0.001) than general PICH (OR = 1.65, 95% CI = 1.25-2.18, P < 0.001) in Asians, and subgroup with controls excluding hypertension had a greater risk (OR = 2.65, 95% CI = 1.78-3.95, P < 0.001) than that including hypertension (OR = 1.50, 95% CI = 1.12-2.02, P = 0.01).
  
  
  CONCLUSIONS
  This meta-analysis suggests that DD homozygote of ACE I/D polymorphism has an increased PICH risk in Asians, and may have a synergistic effect with hypertension.
authors.affiliation: School of Forensic Medicine, Henan University of Science and Technology, Luoyang, China.
authors.forename: Haojie
authors.initials: H
authors.lastname: Qin
authors.forename: Lushun
authors.initials: L
authors.lastname: Zhang
authors.forename: Guohui
authors.initials: G
authors.lastname: Xu
authors.forename: Xinmin
authors.initials: X
authors.lastname: Pan
mesh_terms: D044466:Asian People / Q000235:genetics; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000235:genetics*; D056726:Genetic Association Studies; D006801:Humans; D054643:INDEL Mutation / Q000235:genetics*; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*; D012307:Risk Factors
chemical_list: D007703:Peptidyl-Dipeptidase A