Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and Susceptibility to Osteoarthritis of the Knee: A Case-Control Study and Meta-Analysis

• Published in: PloS one 2016-09, Vol.11 (9), p.e0161754-e0161754
• Main Authors: Lin, Chin, Chen, Hsiang-Cheng, Fang, Wen-Hui, Wang, Chih-Chien, Peng, Yi-Jen, Lee, Herng-Sheng, Chang, Hung, Chu, Chi-Ming, Huang, Guo-Shu, Chen, Wei-Teing, Tsai, Yu-Jui, Lin, Hong-Ling, Lin, Fu-Huang, Su, Sui-Lung
• Format: Article
• Language: English
• Subjects: Alleles; Analysis; Angiotensin; Angiotensin converting enzyme inhibitors; Angiotensins; Biocompatibility; Biology and Life Sciences; Confidence intervals; Control methods; Conversion; Disease; Enzymes; Epidemiology; Epistasis; Gene deletion; Gene polymorphism; Genetic aspects; Genetics; Genotypes; Heterogeneity; Hospitals; Insertion; Knee; Medicine; Medicine and Health Sciences; Meta-analysis; Osteoarthritis; Pain; Pathology; People and Places; Peptidyl-dipeptidase A; Physical Sciences; Polymerase chain reaction; Polymorphism; Population studies; Public health; Research and Analysis Methods; Rheumatoid arthritis; Rheumatology; Studies; Thoracic surgery
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0161754

Studies of angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphisms and the risks of knee osteoarthritis (OA) have yielded conflicting results. To determine the association between ACE I/D and knee OA, we conducted a combined case-control study and meta-analysis. For the case-control study, 447 knee OA cases and 423 healthy controls were recruited between March 2010 and July 2011. Knee OA cases were defined using the Kellgren-Lawrence grading system, and the ACE I/D genotype was determined using a standard polymerase chain reaction. The association between ACE I/D and knee OA was detected using allele, genotype, dominant, and recessive models. For the meta-analysis, PubMed and Embase databases were systematically searched for prospective observational studies published up until August 2015. Studies of ACE I/D and knee OA with sufficient data were selected. Pooled results were expressed as odds ratios (ORs) with corresponding 95% confidence intervals (CI) for the D versus I allele with regard to knee OA risk. We found no significant association between the D allele and knee OA [OR: 1.09 (95% CI: 0.76-1.89)] in the present case-control study, and the results of other genetic models were also nonsignificant. Five current studies were included, and there were a total of six study populations after including our case-control study (1165 cases and 1029 controls). In the meta-analysis, the allele model also yielded nonsignificant results [OR: 1.37 (95% CI: 0.95-1.99)] and a high heterogeneity (I2: 87.2%). The association between ACE I/D and knee OA tended to yield negative results. High heterogeneity suggests a complex, multifactorial mechanism, and an epistasis analysis of ACE I/D and knee OA should therefore be conducted.