Angiotensin-converting enzyme insertion/deletion polymorphism and susceptibility to Kawasaki disease: a meta-analysis

Background: The angiotensin-converting enzyme (ACE) I/D polymorphism has been reported to be associated with Kawasaki disease(KD), but studies to date present conflicting results. Objectives: The aim of this study is to derive a more precise estimation of the association between the ACE I/D polymorphism and KD risk. Methods: PubMed, EMBASE, CNKI and Wangfang databases were retrievaled to identify for relevant studies from inception to May 2017. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using Stata 12.0 software. Results: A total of 6 case-control studies comprising 634 patients and 458 controls were included in the meta-analysis, and we found a significant association between the ACE I/D polymorphism and KD risk(D vs I: OR = 0.81, 95% CI = 0.31-2.11; DD vs II: OR = 1.03, 95% CI = 0.42-2.54; DI vs II: OR = 1.44, 95% CI = 1.09-1.90; dominant model: OR = 1.43, 95% CI = 1.11-1.85; recessive model: OR = 1.21, 95% CI = 0.44-3.29). When stratified by sample size>200, this polymorphism is associated with an increased the risk of KD. Conclusion: The I/D polymorphism in the ACE gene may be associated with susceptibility to KD.