Association of ACE I/D gene polymorphism with vesicoureteral reflux susceptibility in children: a meta-analysis

Background and objective: Many studies have been conducted to investigate the association between angiotensin-converting enzyme (ACE) insertion (I)/deletion (D) gene polymorphism and vesicoureteral reflux (VUR) susceptibility. However, the results from those studies are still conflicting. We performed a meta-analysis of studies relating the ACE I/D gene polymorphism to the risk of VUR. Method: We searched the databases of PubMed, Embase, Cochrane Library and CBM-disc (China Biological Medicine Database) as of 1 March 2011, and recruited the eligible investigations for this meta-analysis. Results: Ten investigations were identified for the analysis of association between ACE I/D gene polymorphism and VUR risk: six in Caucasians, three in East-Asians and one in a Turkish population. All the investigations were performed in children. There was no marked association between ACE I/D gene polymorphism and VUR susceptibility/renal scar for overall populations, Caucasians and East-Asians. In the Turkish population, D allele and DD genotype were associated with the VUR susceptibility/renal scar. Furthermore, ACE I/D gene polymorphism was not associated with VUR progression. Conclusions: D allele and DD genotype are risk factors for the VUR susceptibility/renal scar in Turkish children. However, more case-control association investigations on larger, stratified populations are required in the future.