Abstract
Angiotensin-converting enzyme (
ACE
) gene is indispensable for endothelial control and vascular tone regulatory systems, usually affected in Systemic Lupus Erythematosus (SLE).
ACE
insertion/deletion (I/D) polymorphism may influence the progress of SLE. Earlier studies have investigated this association without any consistency in results. We performed this meta-analysis to evaluate the precise association between
ACE
I/D polymorphism and SLE susceptibility. The relevant studies were searched until December, 2017 using Medline (PubMed), Google-Scholar and EMBASE search engines. Twenty-five published studies involving 3,308 cases and 4,235 controls were included in this meta-analysis. Statistically significant increased risk was found for allelic (D vs. I:
p
= 0.007;
OR
= 1.202, 95%
CI
= 1.052–1.374), homozygous (DD vs. II:
p
= 0.025;
OR
= 1.347, 95%
CI
= 1.038–1.748), dominant (DD+ID vs. II:
p
= 0.002;
OR
= 1.195, 95%
CI
= 1.070–1.334), and recessive (DD vs. ID+II:
p
= 0.023;
OR
= 1.338, 95%
CI
= 1.042–1.718) genetic models. Subgroup analysis stratified by Asian ethnicity revealed significant risk of SLE in allelic (D vs. I:
p
= 0.045;
OR
= 1.238, 95%
CI
= 1.005–1.525) and marginal risk in dominant (DD+ID vs. II:
p
= 0.056;
OR
= 1.192, 95%
CI
= 0.995–1.428) models; whereas, no association was observed for Caucasian and African population. Publication bias was absent. In conclusion,
ACE
I/D polymorphism has significant role in overall SLE risk and it can be exploited as a prognostic marker for early SLE predisposition.