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目的探讨不同人群中血管紧张素转换酶(ACE)基因插入(I)/缺失(D)多态性与IgA肾病(IgAN)发病的关系。方法检索PubMed、Cochrane图书馆、清华同方、重庆维普数据库,时间从该数据库建立至2010年3月1日。全面收集有关IgAN ACE I/D基因多态性研究文献,根据文献纳入标准纳入相关文献。应用Revman 4.2.8软件进行Meta分析,计数资料采用优势比(OR)及其95%CI表示,对IgAN组和健康对照组等位基因D/I,DD/(ID+II)和II/(ID+DD)进行分析。亚组内各研究间无统计学异质性(P≥0.1)时,采用固定效应模型;研究间存在统计学异质性(P<0.1)时,采用随机效应模型。结果纳入20篇符合条件的文献,其中11篇是在亚洲人中进行研究,9篇是对欧洲人群的研究。健康欧洲人群D等位基因的表达比健康亚洲人群高(57.6%vs 32.6%);亚洲人群中D等位基因和DD基因型与IgAN发病关系密切(OR=1.27,P=0.0060;OR=1.83,P<0.0001);而与欧洲人IgAN的发病无明显相关(OR=1.04,P=0.460 0;OR=1.13,P=0.120 0)。在亚洲人群中,II基因型是IgAN发病的一种保护性因素(OR=0.81,P=0.020 0),而欧洲人群未发现有关系(OR=1.05,P=0.580 0)。结论亚洲人ACE I/D基因多态性与IgAN的发病关系密切,而欧洲人群未见两者有联系。
Objective To investigate the relationship between ACE gene insertion (I) / deletion (D) polymorphism and IgA nephropathy (IgAN) in different populations. Methods PubMed, Cochrane Library, Qingfang Tongfang and Chongqing VIP database were searched from the database to March 1, 2010. Comprehensive collection of IgAN ACE I / D gene polymorphism literature, according to the inclusion criteria into the relevant literature. Meta-analysis was performed using Revman 4.2.8 software and the count data were expressed as odds ratios (OR) and 95% CI. The allele D / I, DD / (ID + II) and II / ID + DD) for analysis. Fixed-effect model was used when there was no statistical heterogeneity among all the subgroups (P≥0.1); when the study was statistically heterogeneous (P <0.1), the random effect model was used. Results Twenty eligible articles were included, of which 11 were from Asians and 9 were from European populations. The D allele in healthy European population was higher than that in healthy Asian population (57.6% vs 32.6%). The D allele and DD genotype in Asian population were closely related to IgAN (OR = 1.27, P = 0.0060; OR = 1.83 , P <0.0001). There was no significant correlation between IgAN and European IgAN (OR = 1.04, P = 0.460 0; OR = 1.13, P = 0.120 0). In the Asian population, the genotype II is a protective factor for the pathogenesis of IgAN (OR = 0.81, P = 0.020 0), but not found in European populations (OR = 1.05, P = 0.580 0). Conclusion The ACE I / D gene polymorphism in Asia is closely related to the pathogenesis of IgAN, but no correlation exists between European populations.