Association Between the Angiotensin-Converting Enzyme I/D Polymorphism and Risk of Cerebral Small Vessel Disease: A Meta-Analysis Based on 7186 Subjects

• Published in: Journal of stroke and cerebrovascular diseases Vol. 30; no. 3; p. 105579
• Main Authors: Su, Cheng, Liu, Wen-Chen, Li, Guo-Ming, Huang, Yan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2021
• Subjects: ACE; Angiotensin-converting enzyme; Case-Control Studies; Cerebral small vessel disease; Cerebral Small Vessel Diseases - diagnosis; Cerebral Small Vessel Diseases - ethnology; Cerebral Small Vessel Diseases - genetics; CSVD; Genetic Association Studies; Genetic Predisposition to Disease; Humans; Meta-analysis; Peptidyl-Dipeptidase A - genetics; Phenotype; Polymorphism; Polymorphism, Genetic; Risk Assessment; Risk Factors; CSVD; ACE; Angiotensin-converting enzyme; Cerebral small vessel disease; Polymorphism; Meta-analysis
• ISSN: 1052-3057; 1532-8511; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2020.105579

Cerebral small vessel disease (CSVD) causes a quarter of all strokes and is the most common pathology underlying vascular dementia. However, the mechanism of CSVD remains unclear. Numerous studies have investigated whether the angiotensin-converting enzyme (ACE) intersection/deletion (I/D) polymorphism influences the risk of CSVD, but the results are controversial. We searched English and Chinese databases and calculated the odds ratio (OR) and 95% confidence interval (CI) to examine the existence of genetic associations between the ACE I/D polymorphism and the risk of CSVD. All relevant studies were screened and meta-analyzed using Review Manager 5.4. A total of 27 studies involving 7,186 subjects were identified for the meta-analysis. The results of five genetic models showed a significantly increased risk of CSVD (allelic, OR=1.30; recessive, OR=1.41; dominant, OR=1.34; homozygous, OR=1.55 and heterozygous OR=1.22) in the overall analysis. Furthermore, in subgroup analysis, increased CSVD risks were also observed in Asian and Caucasian populations. We also found no relationship between ACE I/D and leukoaraiosis (LA) in patients with lacunar infarction (LI). The ACE I/D polymorphism was positively associated with CSVD in both populations. However, this polymorphism did not increase the risk of LA in LI patients.