Insertion/Deletion (I/D) Polymorphism of Angiotensin-Converting Enzyme Gene in Steroid-Resistant Nephrotic Syndrome for Children: A Genetic Association Study and Meta-analysis

An assessment of the association of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with steroid-resistant nephrotic syndrome (SRNS) risk in children is still controversial. A meta-analysis was performed to evaluate the relation between ACE gene polymorphisms and SRNS susceptibility. The relevant studies were screened from electronic database and eligible investigations were synthesized using meta-analysis methods. Seven investigations were identified for the analysis of association between ACE I/D gene polymorphism and SRNS risk in children, including five in Asians, one in Caucasians, and one in Africans. There was not a markedly positive association between D allele or DD genotype and SRNS susceptibility in Asians (OR == 1.60, p == 0.26; OR == 1.90, p == 0.38) and for Caucasian population (OR == 0.92, p == 0.86; OR == 0.27, p == 0.22). However, an association of D allele with SRNS susceptibility was observed (OR == 4.67, p == 0.003) in Africans, but not for DD genotype (OR == 6.00, p == 0.05). Interestingly, II genotype seemed to play a positive role against SRNS onset for Asians and African children (OR == 0.51, p == 0.02; OR == 0.07, p == 0.02), but not for Caucasians (OR == 0.33, p == 0.30). In conclusion, our results indicate that D allele or DD homozygous might not be a significant genetic molecular marker for the development of SRNS in Asians and Caucasian children. However, D allele seemed be associated with SRNS risk for Africans but DD genotype did not.