Genetic Association of Angiotensin-Converting Enzyme I/D Polymorphism with Intracranial Hemorrhage: An Updated Meta-analysis of 39 Case-Control Studies.

Abstract

Genetic association studies about associations between angiotensin-converting enzyme (ACE) polymorphisms and intracranial hemorrhage (ICH) generated conflicting results. In this study, a meta-analysis was performed to better assess the relationship between ACE polymorphisms and ICH. PubMed, Medline, Embase, and CNKI were searched for eligible studies. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate associations between ACE polymorphisms and ICH. A total of 39 studies with 3839 cases and 5353 controls were analyzed. Pooled analyses showed that ACE insertion/deletion (I/D) polymorphism was significantly associated with ICH in the overall population (dominant model: P < 0.0001, OR = 0.70, 95% CI 0.60-0.82, I² = 58%; recessive model: P < 0.0001, OR = 1.95, 95% CI 1.57-2.43, I² = 66%; allele model: P < 0.0001, OR = 0.68, 95% CI 0.60-0.78, I² = 75%). Further subgroup analyses yielded similar significant results in individuals of East Asian and South Asian descent, but not in individuals of European descent. This meta-analysis suggests that ACE I/D polymorphism might affect individual susceptibility to ICH in both East Asians and South Asians. These results indicate that this polymorphism could be used to identify individuals at higher susceptibility to ICH in Asians.