Insertion/Deletion (I/D) Polymorphism of Angiotensin-Converting Enzyme Gene in Steroid-Resistant Nephrotic Syndrome for Children: A Genetic Association Study and Meta-analysis

Figures & data

Figure 1. Flow chart for our studies.

Note: ACE, angiotensin-converting enzyme; SRNS, steroid-resistant nephrotic syndrome; CBM, China Biological Medicine; INS, Idiopathic nephrotic syndrome.

Table 1. Characteristics of the studies evaluating the effects of ACE genes on SRNS risk.

		Case			Control			D allele (%)
First author (year)	Ethnicity	DD	ID	II	DD	ID	II	Case	Control
AI-Eisa (2001)	Asian	6	2	0	25	22	1	87.50	75.00
Serdaroglu (2005)	Asian	34	38	11	99	124	64	63.86	56.10
Yang (2005)	Asian	0	5	6	5	22	23	22.73	32.00
Celik (2006)	Asian	3	16	0	51	74	15	57.90	62.86
Tsai (2006)	Asian	4	1	0	2	20	57	90.00	15.19
Sasse (2006)	Caucasian	1	8	1	58	91	50	50.00	52.01
Fahmy (2008)	African	6	8	1	2	8	10	66.67	30.00

Note: ACE, angiotensin-converting enzyme; SRNS, steroid-resistant nephrotic syndrome.

Table 2. Meta-analysis of the ACE polymorphisms and SRNS association.

Genetic contrasts	Group and subgroups	Studies	Q-test p-value	Model selected	OR (95% CI)	p
D versus I	Overall	7	0.001	Random	1.69 (0.88,3.25)	0.12
	Asian	5	0.003	Random	1.60 (0.71,3.61)	0.26
	Caucasian	1	–	Fixed	0.92 (0.38,2.27)	0.86
	African	1	–	Fixed	4.67 (1.69,12.90)	0.003
DD versus (DI+II)	Overall	7	0.0005	Random	1.72 (0.53,5.53)	0.36
	Asian	5	0.0008	Random	1.90 (0.45,8.08)	0.38
	Caucasian	1	–	Fixed	0.27 (0.03,2.18)	0.22
	African	1	–	Fixed	6.00 (1.00,35.91)	0.05
II versus (DI+DD)	Overall	7	0.13	Fixed	0.43 (0.26,0.71)	0.001
	Asian	5	0.17	Fixed	0.51 (0.29,0.88)	0.02
	Caucasian	1	–	Fixed	0.33 (0.04,2.68)	0.30
	African	1	–	Fixed	0.07 (0.01,0.65)	0.02

Note: ACE, angiotensin-converting enzyme; SRNS, steroid-resistant nephrotic syndrome.

Figure 2. Association between D allele and steroid-resistant nephrotic syndrome (SRNS) in Asians.

Figure 3. Association of DD genotype with steroid-resistant nephrotic syndrome (SRNS) in Asians.

Figure 4. Association between II gene and steroid-resistant nephrotic syndrome (SRNS) in Asians.

Table 3. Meta-analysis of the ACE polymorphisms and SRNS association (sensitivity analysis).

Genetic contrasts	Group and subgroups	Number of studies	Q-test p-value	Model selected	OR (95% CI)	p
D versus I	Overall	6	0.0004	Random	1.97 (0.76,5.08)	0.16
	Asian	4	0.001	Random	2.11 (0.51,8.66)	0.30
	Caucasian	1	–	Fixed	0.92 (0.38,2.27)	0.86
	African	1	–	Fixed	4.67 (1.69,12.90)	0.003
DD versus (DI+II)	Overall	6	0.0002	Random	1.95 (0.34,11.08)	0.45
	Asian	4	0.0003	Random	2.46 (0.20,29.84)	0.48
	Caucasian	1	–	Fixed	0.27 (0.03,2.18)	0.22
	African	1	–	Fixed	6.00 (1.00,35.91)	0.05
II versus (DI+DD)	Overall	6	0.08	Random	0.31 (0.08,1.18)	0.09
	Asian	4	0.08	Random	0.44 (0.07,2.81)	0.39
	Caucasian	1	–	Fixed	0.33 (0.04,2.68)	0.30
	African	1	–	Fixed	0.07 (0.01,0.65)	0.02

Note: ACE, angiotensin-converting enzyme; SRNS, steroid-resistant nephrotic syndrome.