The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism has been inconsistently reported to be a risk factor for Childhood immunoglobulin A vasculitis (IgAV) nephritis. We comprehensively searched electronic databases as of Jan 2020. Nineteen studies with 1104 cases and 1589 controls were included. Sensitivity analyses based on different subgroups were performed. Further analyses were conducted for association of ACE polymorphism with disease severity and prognosis. Significant associations were found between ACE I/D polymorphism and childhood IgAV nephritis, with the strongest association in DD vs. II comparison (OR 1.72, 95% CI 1.21–2.46). Subgroup analyses generally showed significant results. Besides, ACE polymorphism was significantly associated with proteinuria (DD + DI vs. II: OR 2.22, 95% CI 1.14–4.33; DI + II vs. DD: OR 0.49, 95% CI 0.30–0.81) and worse prognosis (the strongest effect in DD + DI vs. II: OR 4.43, 95% CI 1.84–10.71) among children with IgAV nephritis. The ACE polymorphism seemed not to be associated with hematuria, hypertension, and renal pathology. This study suggested significant association of ACE gene polymorphism with the risk of IgAV nephritis in children. D allele in the ACE genotype could be a useful genetic marker to predict proteinuria and worse prognosis for childhood IgAV nephritis.

不一致地报道了血管紧张素转换酶（ACE）插入/缺失（I / D）基因多态性是儿童免疫球蛋白A血管炎（IgAV）肾炎的危险因素。截至2020年1月，我们全面搜索了电子数据库。其中包括19项研究，涉及1104例病例和1589例对照。进行了基于不同亚组的敏感性分析。对ACE多态性与疾病严重程度和预后的关联进行了进一步分析。在ACE I / D多态性与儿童IgAV肾炎之间发现显着关联，在DD vs. II比较中关联最强（OR 1.72，95％CI 1.21-2.46）。亚组分析通常显示出显着结果。此外，ACE多态性与蛋白尿显着相关（DD + DI vs. II：OR 2.22，95％CI 1.14–4.33； DI + II vs. II。DD：IgAV肾炎患儿的预后较差（DD + DI对II的作用最强：OR 4.43，95％CI 1.84-10.71），预后较差（DD + DI对II的作用最强：OR 4.43，95％CI 1.84-10.71）。ACE多态性似乎与血尿，高血压和肾病理学无关。这项研究表明ACE基因多态性与儿童IgAV肾炎的风险显着相关。ACE基因型中的D等位基因可能是预测蛋白尿和儿童IgAV肾炎预后较差的有用遗传标记。这项研究表明ACE基因多态性与儿童IgAV肾炎的风险显着相关。ACE基因型中的D等位基因可能是预测蛋白尿和儿童IgAV肾炎预后较差的有用遗传标记。这项研究表明ACE基因多态性与儿童IgAV肾炎的风险显着相关。ACE基因型中的D等位基因可能是预测蛋白尿和儿童IgAV肾炎预后较差的有用遗传标记。