| Objective Angiotensin converting enzyme(ACE)as metal protease,can catalyze angiotensin ? converted to angiotensin ?,and can make slow excitation peptide deactivation;The gene in the 16 th intron 1 287 bp sequence of insertions and deletions,namely the ACE gene I/D polymorphism.Some published case-control study literature discusses the ACE gene I/D polymorphism and the relationship between HSP/HSPN,but the results are not consistent.Collect relevant literature,this study uses the meta-analysis method for comprehensive evaluation of ACE gene I/D polymorphism in various genetic model and the relationship between HSP/HSPN,in order to get more reliable conclusions.Methods Computer retrieval,full system in English term "angiotensn-converting enzyme/Renin-angiotensn system/ACE Gene","HSP/HSPN/Henoch-Schonlein purpura nephritis/Henoch-Schonlein purpura" joint retrieval Pub Med,EMBASE and OVID database;At the same time in Chinese keywords "angiotensin converting enzyme/renin angiotensin system/Ace gene",“Henoch-Schonlein purpura nephritis/Henoch-Schonlein purpura” combine China hownet(CNKI),Wanfang full-text database,VIP Zhong Wen science and technology periodical database(including dissertations and conference papers);And trace the retrieved references,in the systematic review and Meta literature retrieval start-stop time for library until December 30,2015.In strict accordance with the established inclusion criteria selection literature,selected to provide complete data of the case-control study,use Rev Man5.0 study of extracting data analysis software,testing the heterogeneity,If Pheterogenity < 0.10 or I2(%)> 50% choose Random effect model(Random-effect model,REM)analysis,otherwise choose a Fixed effect model(Fixed-effect model and FEM);calculate the combined OR value(Odds thewire,OR) and 95% confidence Interval(95% Confidential Interval,95% CI),at the same time,significance test of the combined effect of value;according to different RACES and meets the HWE inspection separately and combined with sensitivity analysis,and evaluated the stability of the conclusion.Map inverted funnel,Stata12.0 software Egger linear regression method and Beeg rank correlation test and assess the symmetry of inverted funnel figure,validation of publication bias.Results Included in this meta-analysis are case-control studys,13 documents which related to the HSP 7,a total of 1571 cases of the control,including the HSP group of 803 cases in 768 cases and healthy controls,In the racial background characteristics,including three articles respectively from Italy and Turkey,belongs to the Caucasian,the remaining four articles from China,Asian people;2 studies in healthy controls do not conform to the HWE balance(P < 0.05).With 11 references related to the HSPN,a total of 1626 cases of the research object,including HSPN group of 1049 cases in 577 cases and healthy controls,including three articles respectively from Britain and Turkey,belongs to the Caucasian,the rest 8 articles from China,belong to Asian people;6 study of healthy controls do not conform to the HWE balance(P < 0.05).The meta analysis,first of all,on the total population of the genetic model of ACE gene I/D polymorphism and HSP/HSPN susceptibility for correlation analysis.In order to get a more detailed study,will be included in the study according to the population is divided into different ethnic :Asian population and the Caucasus,According to conform to HWE test is divided into: meet HWE,does not conform to the HWE,Further lines of different subgroups of each genetic model related effect value in the merger,the results are as follows:The ACE gene I/D polymorphism HSP and various genetic models of susceptibility in total population:Allele model(D vs I):(OR = 1.21,95% CI: 0.94 ~ 1.55,P = 0.14);Implicit model(DD vs ID + ?):(OR = 1.35,95% CI: 0.90 ~ 2.04,P = 0.15);Dominant model(DD + ID vs ?):(OR = 1.38,95% CI: 0.93 ~ 2.05,P = 0.11);Codominant model(DD vs ?):(OR = 1.76,95% CI: 1.09 ~ 2.83,P = 0.02.Results suggest the ACE gene I/D polymorphism codominant model linked with HSP susceptibility,which,allele model,implicit model,the dominant model has nothing to do with the occurrence of HSP.The ACE gene I/D polymorphism HSPN and various genetic models of susceptibility in total population:Allele model(D vs I):(OR = 1.83,95% CI: 1.56 ~2.14,P < 0.01);Implicit model(DD vs ID + ?):(OR = 2.15,95% CI: 1.43 ~ 3.21,P < 0.01);Dominant model(DD + ID vs ?):(OR = 1.64,95% CI: 1.29 ~ 2.08,P <0.01);Codominant model(DD vs ?):(OR = 2.44,95% CI: 1.80 ~ 3.30,P <0.01).Results suggest the ACE gene I/D polymorphism,implicit model,dominant model,allele model,codominance model are associated with the susceptibility of HSPN.Subgroup analysis of ACE gene I/D polymorphism HSP and various genetic models of susceptibility:allele model(D vs I),in line with the HWE study(OR = 1.28,95% CI: 0.94 ~ 1.74,P = 0.12),Asian people(OR = 1.11,95% CI: 0.82 ~ 1.52,P =0.50),Caucasian population(OR = 1.35,95% CI: 0.85 ~ 2.12,P = 0.20);Implicit model(DD vs ID + ?),in line with the HWE study(OR = 1.42,95% CI: 0.80 ~ 2.54,P =0.23),Asian people(OR = 1.41,95% CI: 0.98 ~ 2.03,P = 0.06),Caucasian population(OR = 1.27,95% CI: 0.49 ~ 3.30,P = 0.62);Dominant model(DD + ID vs ?),in line with the HWE study(OR = 1.44,95% CI: 1.10 ~ 1.90,P = 0.008),Asian people(OR= 1.06,95% CI: 0.67 ~ 1.68,P = 0.81),Caucasian population(OR = 2.29,95% CI: 1.43~ 3.67,P < 0.01);Codominant model(DD vs ?),in line with the study of HWE(OR =2.01,95% CI: 1.37 ~ 2.95,P < 0.01),the Asian population(OR = 1.41,95% CI: 0.80~ 2.49,P = 0.24),Caucasian population(OR = 2.51,95% CI: 1.17 ~ 5.37,P =0.02).Subgroup analysis that the dominant model of Caucasian population and co-dominant model has correlation with HSP susceptibility,codominance model has nothing to do with HSP,Asian people are consistent with the results of the total population.Subgroup analysis of ACE gene I/D polymorphism HSPN and various genetic models of susceptibility:allele model(D vs I),in line with the study of HWE(OR =2.06,95% CI: 1.63 ~ 2.61,P < 0.01),the Asian population(OR = 1.94,95% CI: 1.61~ 2.33,P < 0.01),Caucasian population(OR = 1.55,95% CI: 1.13 ~ 2.11,P < 0.01);Implicit model(DD vs ID + ?),conform to the study of HWE(OR = 3.42,95% CI:2.27 ~ 5.16,P < 0.01),the Asian population(OR = 2.16,95% CI: 1.24 ~ 3.76,P <0.01),Caucasian population(OR = 2.06,95% CI: 1.23 ~ 3.45,P < 0.01);Dominant model(DD + ID vs ?),conform to the study of HWE(OR = 1.99,95% CI: 1.38 ~ 2.88,P < 0.01),the Asian population(OR = 1.71,95% CI: 1.31 ~ 2.23,P < 0.01),Caucasian population(OR = 1.38,95% CI: 0.80 ~ 2.38,P = 0.25);Codominant(DD vs ?)model,in line with the study of HWE(OR = 4.42,95% CI: 2.68 ~ 7.27,P < 0.01),the Asian population(OR = 2.50,95% CI: 1.78 ~ 3.52,P < 0.01),Caucasian population(OR =2.22,95% CI: 1.15 ~ 4.29,P = 0.02).Subgroup analysis that the dominant model of Caucasian population has nothing to do with HSPN,the rest are similar to total population analysis results.About ACE polymorphisms in total population allele model(D vs I)with HSP/HSPN related research of the funnel figure shows no obvious asymmetry,Egger linear regression method(P > 0.05),Begg rank correlation test(P > 0.05)there is no publication bias.Conclutions Always a crowd of ACE gene I/D polymorphism codominant model(DD vs ?)associated with HSP susceptibility;Asian population of all the genetic model has nothing to do with HSP,Caucasian population dominant model(DD + DI v ?)and co-dominant model(DD vs ?)are associated with HSP susceptibility.The total population of ACE gene I/D polymorphism and Asia the crowd allele model(D vs ?),recessive model(DD vs ID + ?),dominant model(DD +ID vs ?),codominance model(DD vs ?)are associated with the susceptibility of HSPN.Caucasian population dominant model(DD + ID vs ?)has nothing to do with HSPN. |
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