Top

Journal of Assisted Reproduction and Genetics

Published in:

01-09-2012 | Genetics

Associations of ACE I/D, AGT M235T gene polymorphisms with pregnancy induced hypertension in Chinese population: a meta-analysis

Authors: Ming Zhu, Jie Zhang, Shaofa Nie, Weirong Yan

Published in: Journal of Assisted Reproduction and Genetics | Issue 9/2012

Abstract

Purpose

There have been many studies concerning the associations of angiotensin-converting enzyme (ACE) I/D, angiotensinogen (AGT) M235T polymorphisms with pregnancy induced hypertension (PIH) among Chinese populations. However, the results were inconsistent, prompting the necessity of meta-analysis.

Methods

Studies published in English and Chinese were mainly searched in EMbase, PubMed and CBM up to January 2012.

Results

Twenty-three studies with 3,551 subjects for ACE I/D and seven studies with 1,296 subjects for AGT M235T were included. Significant associations were found between ACE I/D and PIH under dominant, recessive and allelic models. A separate analysis confined to preeclampsia suggested that ACE I/D was associated with preeclampsia under recessive model and allelic model, but not dominant model. Stratified analyses were conducted as meta-regression analysis indicated that the sample size of case group was a significant source of heterogeneity, which suggested no significant association between ACE I/D and PIH in the subgroup of more than 100 cases. Associations were found between AGT M235T and PIH under dominant genetic model (OR = 1.59; 95 %CI: 1.04–2.42), recessive genetic model (OR = 1.60; 95 %CI: 1.07–2.40), and allelic model (OR = 1.40; 95 %CI: 1.17–1.68). No publication bias was found in either meta-analysis.

Conclusions

The present meta-analysis suggested significant associations between ACE I/D, AGT M235T and PIH in Chinese populations. However, no significant association was found between ACE I/D and PIH in the subgroup of more than 100 cases. Studies with larger sample sizes are necessary to investigate the associations between gene polymorphisms and PIH in Chinese populations.

Ministry of Health PRC. Chinese Health Statistical Digest 2010. http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/ptjnj/year2010/2010t7/sheet001.htm Accessed 21 March 2012.

Irani RA, Xia Y. The functional role of the renin-angiotensin system in pregnancy and preeclampsia. Placenta. 2008;29:763–71.PubMedCrossRef

Anton L, Brosnihan KB. Systemic and uteroplacental renin-angiotensin system in normal and pre-eclamptic pregnancies. Ther Adv Cardiovasc Dis. 2008;2:349–62.PubMedCrossRef

Velloso EP, Vieira R, Cabral AC, Kalapothakis E, Santos RA. Reduced plasma levels of angiotensin-(1-7) and renin activity in preeclamptic patients are associated with the angiotensin I-converting enzyme deletion/deletion genotype. Braz J Med Biol Res. 2007;40:583–90.PubMedCrossRef

Shah DM. The role of RAS in the pathogenesis of preeclampsia. Curr Hypertens Rep. 2006;8:144–52.PubMedCrossRef

Medica I, Kastrin A, Peterlin B. Genetic polymorphisms in vasoactive genes and preeclampsia: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2007;131:115–26.PubMedCrossRef

Guo G, Wilton AN, Fu Y, Qiu H, Brennecke SP, Cooper DW. Angiotensinogen gene variation in a population case-control study of preeclampsia/eclampsia in Australians and Chinese. Electrophoresis. 1997;18:1646–9.PubMedCrossRef

Gurdol F, Isbilen E, Yilmaz H, Isbir T, Dirican A. The association between preeclampsia and angiotensin-converting enzyme insertion/deletion polymorphism. Clin Chim Acta. 2004;341:127–31.PubMedCrossRef

Schmid CH, Stark PC, Berlin JA, Landais P, Lau J. Meta-regression detected associations between heterogeneous treatment effects and study-level, but not patient-level, factors. J Clin Epidemiol. 2004;57:683–97.PubMedCrossRef

10.

Higgins J, Thompson S, Deeks J, Altman D. Statistical heterogeneity in systematic reviews of clinical trials: a critical appraisal of guidelines and practice. J Health Serv Res Policy. 2002;7:51–61.PubMedCrossRef

11.

Li D, Ma Y, Jiang H, Liu C, Li H, Wang R, et al. The association between polymorphisms of angiotensin-converting enzyme and apolipoprotein B and left ventricular hypertrophy in patients with preeclampsia and eclampsia. Xian Dai Fu Chan Ke Jin Zhan. 2005;14:108–14.

12.

Li H, Ma Y, Fu Q, Wang L. Angiotensin-converting enzyme insertion/deletion (ACE I/D) and angiotensin II type 1 receptor (AT1R) gene polymorphism and its association with preeclampsia in Chinese women. Hypertens Pregnancy. 2007;26:293–301.PubMedCrossRef

13.

Song C, Xie S, Tang Y, Wang J, Lian J, Yang L, et al. The gene polymorphisms of the rein-angiotensin system in preeclampisa. Shi Yong Yi Xue Za Zhi. 2007;23:354–7.

14.

Zhan WX, Zheng JS. Relationship between angiotensin converting enzyme gene polymorphism and severe preeclampsia and preeclampisa complication renal dysfunction. Jiang Xi Yi Yao. 2008;43:782–4.

15.

Cui HY, Chen S. Relationship between angiotensin converting enzyme gene polymorphism and early-onset severe preeclampsia. Zhong Guo Fu You Bao Jian. 2008;23:1545–6.

16.

Deng J, You FZ, Cheng GM, Xu YJ. Correlation between gene polymorphisms of ACE, AT1R, eNOS and severe pre-eclampsia. Zhong Guo Fu You Bao Jian. 2010;25:5277–9.

17.

Yue BM, He GL, Liu XH. Polymorphisms of angiotensin-converting enzyme gene in pre-eclampsia. Med J West China. 2011;23:850–3.

18.

Zhu M, Xia Y, Cheng W, Weng H, Zhang Z. Study on a deletion polymorphism of the angiotensin converting enzyme gene in pregnancy induced hypertension. Zhonghua Fu Chan Ke Za Zhi. 1998;33:83–5.PubMed

19.

Zhou N, Yu P, Chen J, Huang H, Jiang S. Detection of insertion/deletion polymorphism of angiotensin converting enzyme gene in preeclampsia. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 1999;16:29–31.PubMed

20.

Wang G, Hua F, Niu J, Li H, Dai Q, Wang J, et al. Relationship of gene polymorphism of angiotensin-converting enzyme and pregnancy induced hypertension. Zhonghua Fu Chang Ke Za Zhi. 1999;34:116.

21.

Hong W, Lin X, Xu Y, Wang Q, Hu Y, Chen Y, et al. Study on insertion/deletion polymorphis of angiotensin-converting enzyme and pregnancy induced hypertension. Wen Zhou Yi Xue Yuan Xue Bao. 2000;30:37–8.

22.

Bai H, Liu X, Liu R, Liu Y, Li M, Liu B. Angiotensinogen and angiotensin-I converting enzyme gene variations in Chinese pregnancy induced hypertension. Hua Xi Yi Ke Da Xue Xue Bao. 2002;33:233–7.PubMed

23.

Gao X, Qiu X, Ye F, Chen L, Xing L, Zhang W. Study on insertion/deletion polymorphism of angiotensin-converting enzyme in women with pregnancy induced hypertension. Zhong Guo Fu You Bao Jian. 2002;17:738–40.

24.

Wu Y, Chen K, Su H, Chen X, Wu Q, Zhen J, et al. Relationship of gene polymorphism of angiotensin-converting enzyme and the morbidity of pregnancy induced hypertension. Zhonghua Fu Chan Ke Za Zhi. 2002;37:30.

25.

Mao D, Li K, Zhao Y, Chen L, Chen S. Study on MTHFR gene and ACE gene polymorphisms in pregnancy induced hypertension. Zhong Hua Wei Chang Yi Xue Za Zhi. 2004;7:22–4.

26.

Wang J, Bu T, Wang Y, Chen P. Relationship between insertion/deletion polymorphism of angiotensin converting enzyme gene and pregnancy-induced hypertension syndrome. Tian Jin Yi Yao. 2004;32:339–41.

27.

Wang C, Fu F, Liao D. Study on detection of insertion/deletion polymorphism of angiotensin-converting enzyme gene in pregnancy induced hypertension. Jiang Xi Yi Xue Yuan Xue Bao. 2004;44:77–81.

28.

Chen B, Zhuo J, Zhou L. Study on the polymorphism of angiotensin I-convertin enzyme gene in pregnancy-induced hypertension syndrome. Jian Yan Yi Xue. 2006;21:39–41.

29.

Li J, Huang Y, Liu X. Study on a deletion polymorphism of the angiotensin-converting enzyme gene in pregnancy induced hypertension. Guang Zhou Yi Xue Yuan Xue Bao. 2006;34:45–52.

30.

Huang Y, Feng Y, Zhu Y, Zuo X. The investigation of gene polymorphisms of angiotensin converting enzyme in family of hypertensive disorder complicating pregnancy. Contemp Med. 2008:8–10

31.

Ren H, Chen B, Liu S, Zhao L, Bo L. Correlation between polymorphism of angiotensin converting enzyme gene and hypertensive disorder complicating pregnancy. Di Si Jun Yi Da Xue Xue Bao. 2008;29:434–6.

32.

Yan W, Kulane A, Xiang P, Li Z, Di H, Nie S. Maternal and fetal angiotensin-converting enzyme gene insertion/deletion polymorphism not associated with pregnancy-induced hypertension in Chinese women. J Matern Fetal Neonatal Med. 2011.

33.

Huang Y, Li Y, Shao J, Sun L. The relationship of polymorphism of RAS genes and interaction with preeclampisa. Yun Nan Yi Yao. 2007;28:8–11.

34.

Wu Z, Jiang H, Wang L, Chen X. The association of angiotensinogen M235T with pregnancy induced hypertension. Zhong Hua Yi Xue Yi Chuan Xue Za Zhi. 2002;19:528–9.

35.

Fu F, Chen Q, Cao Q, He X, Zhang W. The association of gene mutation AGT M235T with pregnancy induced hypertension syndrome. Zhong Hua Lin Chuang Yi Xue Yan Jiu Za Zhi 2003:13191–13192

36.

Hu Y, Wang D, Wu Y. Study on relationship of gene mutation of angiotensinogen with the morbidity of pregnancy induced hypertension. Zhong Guo Shi Yong Fu Ke Yu Chang Ke Za Zhi. 2005;21:315.

37.

Xiang P, Li Z, Di H, Nie S, Yan W. The associations between maternal and fetal angiotensinogen M235T polymorphism and pregnancy-induced hypertension in Chinese women. Reprod Sci. 2011.

38.

Akbar SA, Khawaja NP, Brown PR, Tayyeb R, Bamfo J, Nicolaides KH. Angiotensin II type 1 and 2 receptors gene polymorphisms in pre-eclampsia and normal pregnancy in three different populations. Acta Obstet Gynecol Scand. 2009;88:606–11.PubMedCrossRef

39.

Serrano NC, Diaz LA, Paez MC, Mesa CM, Cifuentes R, Monterrosa A, et al. Angiotensin-converting enzyme I/D polymorphism and preeclampsia risk: evidence of small-study bias. PLoS Med. 2006;3:e520.PubMedCrossRef

40.

Ioannidis JP, Trikalinos TA, Ntzani EE, Contopoulos-Ioannidis DG. Genetic associations in large versus small studies: an empirical assessment. Lancet. 2003;361:567–71.PubMedCrossRef

41.

Pan Z, Trikalinos TA, Kavvoura FK, Lau J, Ioannidis JP. Local literature bias in genetic epidemiology: an empirical evaluation of the Chinese literature. PLoS Med. 2005;2:e334.PubMedCrossRef

42.

Lin J, August P. Genetic thrombophilias and preeclampsia: a meta-analysis. Obstet Gynecol. 2005;105:182–92.PubMedCrossRef

43.

Salonen RH, Lichtenstein P, Lipworth L, Cnattingius S. Genetic effects on the liability of developing pre-eclampsia and gestational hypertension. Am J Med Genet. 2000;91:256–60.CrossRef

44.

Uma R, Forsyth SJ, Struthers AD, Fraser CG, Godfrey V, Murphy DJ. Polymorphisms of the angiotensin converting enzyme gene in early-onset and late-onset pre-eclampsia. J Matern Fetal Neonatal Med. 2010;23:874–9.PubMedCrossRef

45.

Raymond D, Peterson E. A critical review of early-onset and late-onset preeclampsia. Obstet Gynecol Surv. 2011;66:497–506.PubMedCrossRef

46.

Zafarmand MH, Nijdam ME, Franx A, Grobbee DE, Bots ML. The angiotensinogen gene M235T polymorphism and development of preeclampsia/eclampsia: a meta-analysis and meta-regression of observational studies. J Hypertens. 2008;26:1726–34.PubMedCrossRef

47.

Pfab T, Stirnberg B, Sohn A, Krause K, Slowinski T, Godes M, et al. Impact of maternal angiotensinogen M235T polymorphism and angiotensin-converting enzyme insertion/deletion polymorphism on blood pressure, protein excretion and fetal outcome in pregnancy. J Hypertens. 2007;25:1255–61.PubMedCrossRef

48.

Knyrim E, Muetze S, Eggermann T, Rudnik-Schoeneborn S, Lindt R, Ortlepp JR, et al. Genetic analysis of the angiotensinogen gene in pre-eclampsia: study of german women and review of the literature. Gynecol Obstet Invest. 2008;66:203–8.PubMedCrossRef

49.

Disentangling fetal and maternal susceptibility for pre-eclampsia: a British multicenter candidate-gene study. Am J Hum Genet. 2005;77:127–31

50.

Cardon LR, Bell JI. Association study designs for complex diseases. Nat Rev Genet. 2001;2:91–9.PubMedCrossRef

51.

Keavney B, McKenzie C, Parish S, Palmer A, Clark S, Youngman L, et al. Large-scale test of hypothesised associations between the angiotensin-converting-enzyme insertion/deletion polymorphism and myocardial infarction in about 5000 cases and 6000 controls. International Studies of Infarct Survival (ISIS) Collaborators. Lancet. 2000;355:434–42.PubMed

52.

Esplin MS, Fausett MB, Fraser A, Kerber R, Mineau G, Carrillo J, et al. Paternal and maternal components of the predisposition to preeclampsia. N Engl J Med. 2001;344:867–72.PubMedCrossRef

53.

Cnattingius S, Reilly M, Pawitan Y, Lichtenstein P. Maternal and fetal genetic factors account for most of familial aggregation of preeclampsia: a population-based Swedish cohort study. Am J Med Genet A. 2004;130A:365–71.PubMedCrossRef

54.

Vefring HK, Wee L, Jugessur A, Gjessing HK, Nilsen ST, Lie RT. Maternal angiotensinogen (AGT) haplotypes, fetal renin (REN) haplotypes and risk of preeclampsia; estimation of gene-gene interaction from family-triad data. BMC Med Genet. 2010;11:90.PubMedCrossRef

Title: Associations of ACE I/D, AGT M235T gene polymorphisms with pregnancy induced hypertension in Chinese population: a meta-analysis
Authors: Ming Zhu
Jie Zhang
Shaofa Nie
Weirong Yan
Publication date: 01-09-2012
Publisher: Springer US
Published in: Journal of Assisted Reproduction and Genetics / Issue 9/2012
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-012-9800-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Associations of ACE I/D, AGT M235T gene polymorphisms with pregnancy induced hypertension in Chinese population: a meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2012

Efficient combined FISH and PRINS technique for detection of DAZ microdeletion in human sperm

Evaluation of KIR genes in recurrent miscarriage

Proliferation of small number of human spermatogonial stem cells obtained from azoospermic patients

Ectopic pregnancy after IVF in a patient with unilateral agenesis of the fallopian tube and ovary and with endometriosis: search of the literature for these associations

Variation in ovarian follicle density during human fetal development

Routine cryopreservation of spermatozoa is safe — Evidence from the DNA methylation pattern of nine spermatozoa genes