title: Angiotensin converting enzyme (I/D) gene polymorphism contributes to ischemic stroke risk in Caucasian individuals: a meta-analysis based on 22 case-control studies.
abstract: BACKGROUND
  Stroke is a multifactorial disease in which genetic factors play an important role. Previous studies associated angiotensin converting enzyme (ACE) (insertion/deletion, I/D) gene polymorphism with ischemic stroke risk in Caucasian individuals reported conflicting results. The purpose of this study was to evaluate the association between ACE (I/D) gene polymorphism and ischemic stroke risk by a meta-analysis.
  
  
  METHODS
  The related studies were searched in MEDLINE, EMBASE and HuGEnet databases. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for ischemic stroke risk associated with this polymorphism were estimated using fixed-effect or random-effects model. Twenty-two studies (5528/5081 cases/controls) were eligible in our meta-analysis.
  
  
  RESULTS
  Overall, statistical associations of the ACE (I/D) polymorphism with ischemic stroke risk were found in dominant model (DD + ID versus II) : OR = 1.21, 95% CI = (1.06,1.38), P = 0.006, recessive model (DD versus ID + II): OR = 1.28, 95% CI = (1.05,1.55), P = 0.01, and homozygote comparison (DD versus II): OR = 1.37, 95% CI = (1.14,1.65), P = 0.001 for Caucasians. When stratifying according to stroke subtypes, there were similarly significant differences for small vessel disease in dominant model (DD + ID versus II) : OR = 1.44, 95% CI = (1.01,2.05), P = 0.04, recessive model (DD versus ID + II): OR = 1.30,95% CI = (1.09,1.55), P = 0.004, and homozygote comparison (DD versus II): OR = 1.44, 95% CI = (1.15,1.80), P = 0.001.
  
  
  CONCLUSIONS
  This analysis suggests that the ACE (I/D) polymorphism may be a risk factor for ischemic stroke, genotype DD of ACE could increase the risk of ischemic stroke in Caucasians. Subgroup analyses indicate that stroke subtypes may be a genetic risk factor of ischemic stroke, and there might be a greater genetic liability with small vessel disease.
authors.affiliation: a 1 Department of Rehabilitation Medicine, the Second People's Hospital of Hefei City , 246th Heping Road, Hefei 230011, Anhui Province, China and.
authors.forename: Hai
authors.initials: H
authors.lastname: Yuan
authors.affiliation: b 2 Department of Neurology, the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province , China.
authors.forename: Xiaotong
authors.initials: X
authors.lastname: Wang
authors.affiliation: a 1 Department of Rehabilitation Medicine, the Second People's Hospital of Hefei City , 246th Heping Road, Hefei 230011, Anhui Province, China and.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
authors.affiliation: a 1 Department of Rehabilitation Medicine, the Second People's Hospital of Hefei City , 246th Heping Road, Hefei 230011, Anhui Province, China and.
authors.forename: Pingping
authors.initials: P
authors.lastname: Ge
authors.affiliation: a 1 Department of Rehabilitation Medicine, the Second People's Hospital of Hefei City , 246th Heping Road, Hefei 230011, Anhui Province, China and.
authors.forename: Xiumin
authors.initials: X
authors.lastname: Wang
authors.affiliation: a 1 Department of Rehabilitation Medicine, the Second People's Hospital of Hefei City , 246th Heping Road, Hefei 230011, Anhui Province, China and.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Cao
keywords: angiotensin converting enzyme; ischemic stroke; meta-analysis; polymorphism