I/D polymorphism of ACE and risk of diabetes-related end-stage renal disease: a systematic review and meta-analysis

W. Shen, X.-X. Jiang, Y.-W. Li, Q. He

Department of Nephrology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Key Laboratory of Kidney Disease of Traditional Chinese Medicine in Zhejiang Province, Hangzhou, Zhejiang, P. R. China. gongzuogong@163.com

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• Nephrology

OBJECTIVE: We conducted a meta-analysis on exploring the correlation between I/D polymorphism of ACE and risk of diabetes mellitus-related end-stage renal disease.

MATERIALS AND METHODS: Researches on the correlation between I/D polymorphism of ACE and the risk of diabetes-related end-stage renal disease were searched in the three online databases (PubMed, Embase, and Cochrane Library). Citations of related researches were manually examined and enrolled. This study systematically searched relative literature for cohort studies or case-control studies published in the English language until December 1, 2018. Researches containing odds ratio (OR) and 95% confidence interval (CI) calculated based on the correlation between I/D polymorphism of ACE and the risk of diabetes-related end-stage renal disease were enrolled. The included data were weighted by an inverse variance and then analyzed by a fixed or random effects model. Researches met the inclusion criteria were extracted for relevant data and subjected to a heterogeneity test. The effect size was calculated by STATA 12.0 software for meta-analysis.

RESULTS: A total of 15 articles including 1199 cases of diabetes-related end-stage renal disease and 2939 cases of controls were enrolled. I/D polymorphism of ACE remarkably increased the risk of diabetes-related end-stage renal disease. In the subgroup analysis by ethnicity, a significant difference in risk of diabetes-related ESRD was only detected in the Asian population with I/D polymorphism of ACE. However, no significant difference in disease risk was found in the Caucasian population.

CONCLUSIONS: This meta-analysis suggested that I/D polymorphism of ACE can markedly increase the incidence of diabetes-related end-stage renal disease, especially in Asian populations.

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