Meta-analysis of the association between angiotensin-converting enzyme I/D polymorphism and aortic aneurysm risk

Background: Angiotensin-converting enzyme (ACE) I/D polymorphism has been indicated to be correlated with aortic aneurysm (AA) susceptibility, but study results are still debatable. Thus, a meta-analysis was conducted. Methods: Databases including PubMed, Embase, Web of Science, and Chinese National Knowledge Infrastructure (CNKI) were searched. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Ten studies with 3557 cases and 5231 controls were included in this meta-analysis. The association between ACE I/D genotype and AA risk was significant (OR=1.30; 95%CI, 1.07–1.57; p<0.01; I 2 =68%). When stratified by ethnicity, a significantly elevated risk was observed in Caucasians (OR=1.31; 95%CI, 1.07–1.61; p<0.01; I 2 =71%). In the abdominal AA subgroup, a significantly increased risk was observed (OR=1.29; 95%CI, 1.03–1.62; p=0.02; I 2 =73%). However, ACE I/D polymorphism was not associated with thoracic AA risk (OR=1.33; 95%CI, 0.85–2.07; p=0.21; I 2 =52%). Subgroup analysis on blood pressure status showed that an increased risk was found in hypertensive patients (OR=1.52; 95%CI, 1.02–2.26; p=0.04; I 2 =0%) but not in normotensive subjects (OR=1.46; 95%CI, 0.72–2.96; p=0.30; I 2 =25%). Conclusions: In conclusion, this meta-analysis suggested that ACE I/D polymorphism is a risk factor for AA.