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A Pooled Study of Angiotensin-Converting Enzyme Insertion/Deletion Gene Polymorphism in Relation to Risk, Pathology and Prognosis of Childhood Immunoglobulin A Vasculitis Nephritis

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Abstract

The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism has been inconsistently reported to be a risk factor for Childhood immunoglobulin A vasculitis (IgAV) nephritis. We comprehensively searched electronic databases as of Jan 2020. Nineteen studies with 1104 cases and 1589 controls were included. Sensitivity analyses based on different subgroups were performed. Further analyses were conducted for association of ACE polymorphism with disease severity and prognosis. Significant associations were found between ACE I/D polymorphism and childhood IgAV nephritis, with the strongest association in DD vs. II comparison (OR 1.72, 95% CI 1.21–2.46). Subgroup analyses generally showed significant results. Besides, ACE polymorphism was significantly associated with proteinuria (DD + DI vs. II: OR 2.22, 95% CI 1.14–4.33; DI + II vs. DD: OR 0.49, 95% CI 0.30–0.81) and worse prognosis (the strongest effect in DD + DI vs. II: OR 4.43, 95% CI 1.84–10.71) among children with IgAV nephritis. The ACE polymorphism seemed not to be associated with hematuria, hypertension, and renal pathology. This study suggested significant association of ACE gene polymorphism with the risk of IgAV nephritis in children. D allele in the ACE genotype could be a useful genetic marker to predict proteinuria and worse prognosis for childhood IgAV nephritis.

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Acknowledgements

This work is supported by Doctoral Research Fund from the First Affiliated Hospital of Anhui Medical University (BSKY2019027).

Funding

Doctoral Research Fund from the First Affiliated Hospital of Anhui Medical University (BSKY2019027).

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Authors and Affiliations

  1. Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China

    Gao Hui, Hua Ran, Wang Ziwei & Deng Fang

  2. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Gao Hui & Deng Fang

  3. Anhui Provincial Cancer Institute, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China

    Zhang Cheng

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  1. Gao Hui
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  3. Hua Ran
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  4. Wang Ziwei
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  5. Deng Fang
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Contributions

GH: study design, literature search, data extraction, statistical analysis, interpretation of results, and paper writing; ZC: literature search, data extraction, and statistical analysis; HR: guidance of clinical knowledge and interpretation of results; WZW: review and revise after the completion of the first draft for detail; DF: principal investigator, study design, quality control, interpretation of results, and review the whole manuscript.

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Correspondence to Gao Hui or Deng Fang.

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Hui, G., Cheng, Z., Ran, H. et al. A Pooled Study of Angiotensin-Converting Enzyme Insertion/Deletion Gene Polymorphism in Relation to Risk, Pathology and Prognosis of Childhood Immunoglobulin A Vasculitis Nephritis. Biochem Genet 59, 202–218 (2021). https://doi.org/10.1007/s10528-020-09999-2

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