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.