A Pooled Study of Angiotensin-Converting Enzyme Insertion/Deletion Gene Polymorphism in Relation to Risk, Pathology and
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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 Gao Hui1,2 · Zhang Cheng3 · Hua Ran1 · Wang Ziwei1 · Deng Fang1,2 Received: 26 February 2020 / Accepted: 18 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Angiotensin-converting enzyme · Genetic polymorphism · Immunoglobulin A vasculitis nephritis · Disease susceptibility
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s1052 8-020-09999-2) contains supplementary material, which is available to authorized users. * Gao Hui [email protected] * Deng Fang [email protected] Extended author information available on the last page of the article
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Biochemical Genetics
Introduction Immunoglobulin A vasculitis (IgAV) is a small-vessel leucocytoclastic vasculitis which can result in majority kinds of clinical symptoms in different organs (Calvino et al. 2001). People of all ages could suffer from IgAV; however, up to 90% of them are children under 10 years old (Saulsbury 2007). IgAV is often self-limited in children but renal involvement, namely IgAV nephritis, can occur within 6 months from IgAV onset in approximately 40% of children (Edstrom et al. 2010; Saulsbury 2007). IgAV nephritis is considered as a leading reason of chronic renal failure in child patients (Guo et al. 2013; Scharer et al. 1999). Nearly 7—23% of children with IgAV nephritis would progress to end-stage renal disease (ESRD) (Butani and Morgenstern 2007; Coppo et al. 1997). Therefore, IgAV nephritis i
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