Introduction

Cerebral small vessel disease (CSVD) causes a quarter of all strokes and is the most common pathology underlying vascular dementia. However, the mechanism of CSVD remains unclear. Numerous studies have investigated whether the angiotensin-converting enzyme (ACE) intersection/deletion (I/D) polymorphism influences the risk of CSVD, but the results are controversial.

Methods

We searched English and Chinese databases and calculated the odds ratio (OR) and 95% confidence interval (CI) to examine the existence of genetic associations between the ACE I/D polymorphism and the risk of CSVD. All relevant studies were screened and meta-analyzed using Review Manager 5.4.

Results

A total of 27 studies involving 7,186 subjects were identified for the meta-analysis. The results of five genetic models showed a significantly increased risk of CSVD (allelic, OR=1.30; recessive, OR=1.41; dominant, OR=1.34; homozygous, OR=1.55 and heterozygous OR=1.22) in the overall analysis. Furthermore, in subgroup analysis, increased CSVD risks were also observed in Asian and Caucasian populations. We also found no relationship between ACE I/D and leukoaraiosis (LA) in patients with lacunar infarction (LI).

Conclusion

The ACE I/D polymorphism was positively associated with CSVD in both populations. However, this polymorphism did not increase the risk of LA in LI patients.

中文翻译：

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血管紧张素转换酶I / D多态性与脑小血管疾病风险之间的关联：基于7186位受试者的荟萃分析

介绍

脑小血管疾病（CSVD）导致所有中风的四分之一，是血管性痴呆的最常见病理。但是，CSVD的机制仍不清楚。大量研究调查了血管紧张素转换酶（ACE）交/缺失（I / D）多态性是否影响CSVD的风险，但结果尚存争议。

方法

我们搜索了英文和中文数据库，并计算了优势比（OR）和95％置信区间（CI），以检查ACE I / D多态性与CSVD风险之间存在遗传关联。使用Review Manager 5.4对所有相关研究进行筛选和荟萃分析。

结果

荟萃分析共鉴定了27项研究，涉及7,186名受试者。五个遗传模型的结果显示，在总体分析中，CSVD的风险显着增加（等位基因，OR = 1.30；隐性，OR = 1.41；显性，OR = 1.34；纯合，OR = 1.55和杂合OR = 1.22）。此外，在亚组分析中，在亚洲和高加索人群中还发现CSVD风险增加。我们还发现腔隙性脑梗死（LI）患者的ACE I / D与白细胞疏松症（LA）之间没有关系。

结论

在这两个人群中，ACE I / D多态性均与CSVD正相关。但是，这种多态性并未增加LI患者发生LA的风险。