Genetically-reduced serum ACE activity might be a causal risk factor for obstructive sleep apnea syndrome: A meta-analysis.
We meta-analytically summarized the associations of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with ACE activity and obstructive sleep apnea syndrome (OSAS) to see whether ACE activity is causally associated with OSAS. Literature search and data abstraction were done in duplicate. Sixteen articles including 2060 OSAS patients and 1878 controls were summarized. Overall, no significance was observed for the association of I/D polymorphism with OSAS, whereas carriers of II genotype (weighted mean difference or WMD, 95% confidence interval or CI, P: -11.976, -17.168 to -6.783, <0.001) or I allele (-9.842, -14.766 to -4.918, <0.001) had a lower level of serum ACE activity compared with DD genotype carriers, respectively. In subgroup analyses, carriers of II genotype were 3.806 times more likely to develop OSAS (95% CI, P: 1.865 to 7.765, <0.001) in OSAS patients with hypertension, without heterogeneity. Mendelian randomization analysis indicated there was 37.4% (95% CI: 1.115 to 3.142) and 32.4% (1.106 to 2.845) increased risk of OSAS by a reduction of 1 U/L in ACE activity for the II genotype and I allele carriers versus DD genotype carriers, respectively. There was no observable publication bias. Collectively, genetically-reduced serum ACE activity might be a causal risk factor for OSAS.
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Lan
L
He
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Bin
B
Wang
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Wei-Ya
WY
Lang
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Jing
J
Xue
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Da-Long
DL
Zhao
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Guo-Feng
GF
Li
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Li-Hong
LH
Zheng
Basic Medical Science College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.
Hong-Ming
HM
Pan
D000483:Alleles; D005260:Female; D056726:Genetic Association Studies; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000235:genetics*; D054643:INDEL Mutation; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000097:blood / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000235:genetics* / Q000473:pathology
C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A