Zhang, Yongjun; Yang, Tao; Zhou, Wenjiao; Huang, Yuee

doi:10.1590/1806-9282.65.6.923

Acessibilidade / Reportar erro

Brasil

Revista da Associação Médica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review Article • Rev. Assoc. Med. Bras. 65 (6) • Jun 2019 • https://doi.org/10.1590/1806-9282.65.6.923 copiar

A meta-analysis on the association of genetic polymorphism of the angiotensin-converting enzyme and coronary artery disease in the chinese population

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

OBJETIVO:

Investigar a associação entre o polimorfismo de inserção ou deleção do genótipo do gene da enzima conversora da angiotensina (ACE) e a susceptibilidade da etnia Han chinesa para a doença arterial coronariana (DAC).

Métodos:

Foi realizada uma pesquisa abrangente para o valor de OR (Odds Ratio) de contraste entre o grupo de polimorfismo de inserção ou deleção do genótipo do gene da enzima conversora da angiotensina (ACE) e o grupo de doença arterial coronariana (DAC) como um índice de eficácia. Uma meta-análise (Stata 12,0) foi utilizada para testar a heterogeneidade dos resultados, combinar os valores de eficácia, realizar análises de sensibilidade e de avaliação básica.

RESULTADOS:

Um total de 638 estudos foram encontrados sobre a associação entre polimorfismos do gene da enzima conversora da angiotensina e doença arterial coronariana, dos quais 44 satisfaziam os critérios de inclusão. Nosso estudo incluiu 6246 casos e 5713 controles. O teste de heterogeneidade de cada estudo (p < 0,001) foi realizado seguindo o modelo de efeito randômico. O valor de OR para DD/ID+II foi 1,95, com 95% de intervalo de confiança de (95%CI) (1,66-2,29). O valor de OR para II/DI+DD foi 0,63, com 95% IC (0,55-0,72). A figura do funil é basicamente simétrica e os resultados da análise de sensibilidade foram estáveis.

CONCLUSÃO:

O genótipo DD do gene da enzima conversora da angiotensina podem ser um fator de risco mais fraco para doença coronariana na população chinesa Han.

PALAVRAS-CHAVE:
Peptidil Dipeptidase A; Polimorfismo Genético; Doença da Artéria Coronariana; Metanálise

First author	Year	Region	CAD patients		non-CAD control		NOS score
First author	Year	(province/city)	Total	D frequency	Total	D frequency	NOS score
Xiang et al.¹⁰10. Xiang C, Wang Y, Wu S. Relationship between angiotensin converting enzyme gene and coronary heart disease diabetes and hypertension in Chinese. Chinese J Endocrine Metabolism. 1995(4):201-5.	1995	shanghai	80	0.64	48	0.38	7
Kario et al.¹¹11. Kario K, Kanai N, Saito K, Nago N, Matsuo T, Shimada K. Ischemic stroke and the gene for angiotensin-converting enzyme in Japanese hypertensives. Circulation. 1996;93(9):1630-3.	1996	china	276	0.409	147	0.411	8
Gu et al.¹²12. Gu H, Zhang H, Wang Y, Jiang Y. The relationship between insertion/deletion polymorphism of angiotensin-converting enzyme gene and coronary heart disease. J Capital University Medical Sciences. 1998;19(3):228-30.	1998	beijing	95	0.54	100	0.35	8
Shi et al.¹³13. Shi Y, Shan J, Li D. Association of angiotensin converting enzyme gene polymorphism with coronary heart disease in Chinese. Chin J Intern Med. 1998;37(12):815-8.	1998	zhejiang	148	0.446	159	0.425	7
Qiu et al.¹⁴14. Qiu Y, Dai L, Shen C. Association of ACE gene polymorphism with coronary heart disease and hypertension. Zhejiang Medicine. 1999;(5):261-2.	1999	zhejiang	73	0.58	102	0.38	8
Jia et al.¹⁵15. Jia Y, Yang D, Yang Z. Analysis of angiotensin converting enzyme gene insertion/deletion polymorphism in patients with coronary heart disease. Jiangsu Medicine. 1999;(6):262-3.	1999	jiangsu	187	0.497	160	0.537	8
Sui et al.¹⁶16. Sui J, Li W, Peng X. The relationship between angiotensin-converting enzyme gene polymorphism and coronary heart disease. Tianjin Med J. 1999;27(12):707-10.	1999	tianjing	40	0.46	50	0.4	7
Tan et al.¹⁷17. Tan H, Zhang G, Huang C, Zhu K, Pan Q. Angiotensin 1-converting enzyme gene insertion/deletion polymorphism in patients with coronary artery disease and essential hypertension and its nucleotide sequence. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 1999;16(3):145-8.	1999	shandong	137	0.639	63	0.436	8
Shi et al.¹⁸18. Shi Q, Zhang X, Chen L. Relationship between coronary collateral circulation and angiotensin converting enzyme gene polymorphism of patients with coronary heart disease. Shandong Med J. 2000;40(17):1-3.	2000	tianjing	169	0.583	94	0.441	8
Xie et al.¹⁹19. Xie Y, Zhang F, Wenzhu MA. Association between gene polymorphism of renin-angiotensin system and coronary heart disease. Acta Universitatis Medicinalis Nanjing. 2001;21(6):488-91.	2001	jiangsu	106	0.44	86	0.36	7
Chen et al.²⁰20. Chen J, Zhang J, Cheng L. Correlation of angiotensin-converting enzyme gene I/D polymorphism with coronary heart disease and the pathogenesis. J Clin Cardiol (China). 2001; 7(6):254-6.	2001	hubei	51	0.422	30	0.3	8
Deng et al.²¹21. Deng J, Zhou Y, Huang D, Yue J, Wang Y, Zhang X, et al. Relation between coronary artery disease and polymorphism of angiotensin converting enzyme gene. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2002;19(1):105-7.	2002	sichuan	55	0.34	102	0.36	7
Liu et al.²²22. Liu H, Chao L, Liao S. Relationship between angiotensin converting enzyme gene polymorphism, angiotensin converting enzyme activity and coronary heart disease. J Chinese Physician. 2002;4(5):483-5.	2002	jiling	51	0.61	83	0.45	8
Su et al.²³23. Su W, Zhu J, Zhang D, Yang Z. Relationship of angiotensin converting enzyme gene polymorphism with coronary artery disease. Acta Academiae Medicinae Nantong. 2002;22(2):145-8.	2002	jiangsu	157	0.5637	112	0.3884	7
Zhu et al.²⁴24. Zhu TB, Xu L, Yang ZJ. Analysis of relationship between three key gene polymorphisms of renin angiotensin system and coronary heart disease. Jiangsu Med J. 2002;28(10):745-6.	2002	jiangsu	140	0.421	106	0.3585	8
Zhang et al.²⁵25. Zhang R, Wang S, Dai Y. Correlation between angiotensin converting enzyme gene polymorphism and coronary heart disease. J Pract Med. 2003;19(3):260-1.	2003	guangdong	102	0.43	148	0.33	7
Huang et al.²⁶26. Huang Z, Shi J, Zhang D. Correlation between angiotensin converting enzyme gene polymorphism and coronary heart disease. J Qiqihar Medical College. 2003;24(4):385-6.	2003	jiangsu	89	0.567	75	0.413	8
Mao et al.²⁷27. Mao Y, Yuan Z, Huang X. The association between the deletion/insertion polymorphism of angiotensin converting enzyme and coronary heart disease in human Han population. Chin J Arterioscler. 2004;12(2):215-7.	2004	hunan	100	0.64	54	0.4537	7
Wang et al.²⁸28. Wang W, Ma Y. Association between I/D genetic polymorphism of angiotensin converting enzyme and the risk of coronary artery disease. J Clin Cardiol (China). 2004;20(6):325-7.	2004	hubei	50	0.6	56	0.41	9
Zhu et al.²⁹29. Zhu TN, Pan JX, Shen ZJ. Renin-angiotensin system gene polymorphism and coronary thrombosis. J Exp Hematol. 2004;12(05):122-7.	2004	beijing	192	0.359	98	0.342	7
Lin et al.³⁰30. Lin X, Wang M, Xia X. A study on relationship between the genetic polymorphism s of angiotensin system and the risk of coronary artery disease. J Chinese Physician. 2005;7(12):1593-5.	2005	guangdong	72	0.417	50	0.350	8
Wang et al.³¹31. Wang M, Lin XX, Xia XM. Correlation between angiotensin system gene polymorphism and premature coronary heart disease. Clin Med China. 2006;(11):971-4.	2006	guangdong	105	0.4381	50	0.32	8
Shi et al.³²32. Shi YP, Meng WH, Shan J. Relationship between angiotensin-converting enzyme gene polymorphism and severity of coronary heart disease and coronary atherosclerosis. J Zhejiang University (Medical Sciences). 2006;35(3):61-5.	2006	zhejiang	169	0.49	168	0.4167	9
Wang³³33. Wang SQ. Association between angiotensin-converting enzyme and angiotensinogen gene polymorphisms and coronary heart disease. Nanchang University; 2006.	2006	jiangxi	161	0.56	109	0.46	7
Yang et al.³⁴34. Yang L-X, Shi Y-K, Wang X-M. Clinical research of polymorphism of ACE gene and vessel reactive substances in coronary heart disease patients. J Pract Med. 2007;23(7):978-80.	2007	sichuan	80	0.581	80	0.413	7
Li et al.³⁵35. Li L, Wang M, Zhao H, Wu S. Analysis of angiotensin converting enzyme gene polymorphism in patients with coronary heart disease. Shandong Med. 2008;42(2):41-2.	2008	hebei	80	0.63	100	0.62	8
Jia et al.³⁶36. Jia Y-P, Guo X-H, Yang J-P. Association between gene polymorphism of renin-angiotensin system and coronary heart disease. Chin J Arterioscler. 2008;16(12):981-5.	2008	shanxi	110	0.605	80	0.444	8
Shi et al.³⁷37. Shi Y, Yang L, Qi F. Clinical research of polymorphism of ACE gene and severity of coronary artery stenosis in coronary heart disease. Chongqing Med. 2008;37(23):2660-2.	2008	sichuan	80	0.56	80	0.41	8
Zhao et al.³⁸38. Zhao GD, Zhou PF, Cai ZY. Study on relationship between angiotensin-converting enzyme gene polymorphism and Chinese medical syndromes of coronary angina pectoris. Shanghai J Traditional Chinese Med. 2008;(7):8-10.	2008	shang hai	115	0.46	47	0.34	8
Yun et al.³⁹39. Yun ML, Zhong JH, Zheng Y. Correlation of ACE gene polymorphisms with coronary heart disease in Han nationality in Hainan Province. China Tropical Medicine. 2009;9(4):625-7.	2009	hai nan	150	0.46	150	0.343	7
Yang et al.⁴⁰40. Yang ZW, Feng XL, Liang XA. Association between angiotensin-converting enzyme gene polymorphism and coronary heart disease in Han nationality in Xinjiang. Chinese J Gerontol. 2009;29(21):2718-9.	2009	xin jiang	42	0.4405	82	0.36	7
Chen⁴¹41. Chen J. Relationship of angiotensin-converting enzyme gene polymorphism with blood stasis syndrome in premature coronary heart disease. Human Academy of Chinese Medicine; 2009.	2009	hu nan	86	0.57	38	0.25	8
Xie et al.⁴²42. Xie JM, Feng XM, Qin WB. Relationship between the I/D polymorphism of angiotensin converting enzyme gene and coronary heart disease in Hans of Baotou area in Inner Mongolia. Chinese J Clinical Pathologist. 2009;1(1):6-8.	2009	nei menggu	94	0.367	67	0.358	8
Liu and He⁴³43. Liu JO, He LX. The polymorphism in intron16 of ace in the populations of CHD in Chinese Hans. Chinese J Birth Health & Heredity. 2010;18(10):23-4.	2010	nei menggu	54	0.6665	88	0.4886	7
Wang et al.⁴⁴44. Wang SQ, Wu YQ, Chen XS. Relationship between angiotensin-converting enzyme and angiotensinogen gene polymorphism and coronary heart disease. J Nanchang University (Medical Sciences). 2010;50(8):8-11.	2010	jiang xi	158	0.55	109	0.47	7
Yang et al.⁴⁵45. Yang ZX, Jiang DJ, Liu K. ACE gene polymorphism and coronary heart disease study. Guide of China Medicine. 2011;9(36):22-3.	2011	shan dong	146	0.55	113	0.46	7
Peng et al.⁴⁶46. Peng J, Luo LY, Li T. Relationship between renin-angiotensin system gene polymorphism and ischemic chronic heart failure in aged coronary artery disease patient. Chinese Circulation J. 2011;26(2):93-6.	2011	guang dong	196	0.643	200	0.435	8
Yi et al.⁴⁷47. Yi SD, Gong ZH, Xiang DC. Correlation between angiotensin-converting enzyme gene I/D polymorphism and coronary heart disease. Shandong Med J. 2011;51(12):57-8.	2011	guang dong	180	0.609	180	0.467	8
Wang et al.⁴⁸48. Wang CL, Qi QX, Zhu YM. Correlation between angiotensin-converting enzyme gene I/D polymorphism in Han nationality patients with coronary heart disease in Qinghai Province. Qinghai Medical J. 2012;42(9):1-3.	2012	qing hai	89	0.567	75	0.413	8
Hu et al.⁴⁹49. Hu ZX, Hu SY, Li L. Impact of polymorphism of angiotensin converting enzyme gene on premature coronary heart disease with blood stasis syndrome. Chinese J Integrative Med Cardio-Cerebrovascular Disease. 2013;11(5):515-8.	2013	hu nan	86	0.57	38	0.25	7
Zhao et al.⁵⁰50. Zhao P, Zhao H, Cao XY. Correlation between gene polymorphism of angiotensin-converting enzyme and coronary heart disease in population of Han nationality in Tangshan region. Chinese J Evidence-Based Cardiovascular Med. 2015;7(2):221-4.	2015	he bei	233	0.51	99	0.42	7
Zhang et al.⁵¹51. Zhang XL, Liang ZY, Sun Y. Association of ACE gene I/D variant with coronary artery disease. Progress in Modern Biomedicine. 2016;16(6):1036-8.	2016	liao ning	568	0.345	580	0.267	8
Jing et al.⁵²52. Jing Z, Lin LU, Yong-Nian L, Zhan-Hai SU, Ying-Zhong Y. Association study between the angiotensin converting enzyme gene insertion/deletion polymorphism and Qinghai Han Chinese with congenital heart disease. Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2016;32(6):499-503.	2016	qing hai	59	0.305	193	0.35	8
Dai⁵³53. Dai SH. Association of serum levels of AnglI, KLKl and ACE/KLKl polymorphisms with acute myocardial infarction. Shandong University;2017. p.1-57.	2017	shan dong	208	0.45	216	0.34	8

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR: Yuee Huang, No. 22, Wenchang West Road, Yijiang District, Wuhu City, Anhui Province – WuHu, China – 241002 E-mail: huangyewindow@163.com

Study group (N° of studies)	N° of patients with DD genotype/DI and II N° of patients		Combined OR(95%-CI)	N° of patients with II genotype/ DI and DD N° of patients		Combined OR(95%-CI)
Study group (N° of studies)	CAD cases	No CAD controls	Combined OR(95%-CI)	CAD cases	No CAD controls	Combined OR(95%-CI)
<100 cases (2)	23/68	11/69	2.303[0.772,6.870]	34/57	33/47	0.792[0.422,1.488]
100-200 cases (22)	581/1211	283/1298	2.311 [1.883, 2.836]	439/1353	593/988	0.499[0.406, 0.612]
≥200 case (20)	1002/2734	577/2627	1.680 [1.337, 2.111]	1222/2514	1276/1928	0.745[0.632, 0.879]
Test for heterogeneity	Q=7.54	P=0.023		Q=11.98	P=0.003
Combined OR (95%CI)	1.919	[1.510, 2.438]		0.659	[0.505, 0.860]
	Z=5.33	P<0.001		Z= 3.07	P=0.002