Renin–angiotensin–aldosterone system gene polymorphisms and type 2 diabetic nephropathy in asian populations: An updated meta-analysis

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Abstract

Background: The association of polymorphisms in the renin-angiotensin-aldosterone system candidate genes, namely Angiotensin-Converting Enzyme (ACE) Insertion/Deletion (I/D), Angiotensinogen (AGT) M235T and Angiotensin II Receptor Type 1 (AGTR1) A1166C with Diabetic Nephropathy (DN) has been studied for decades. Objective: This meta-analysis aimed to assess the updated pooled effects of these polymorphisms with DN among Asian populations with type 2 diabetes mellitus. Methods: The PubMed electronic database was searched without duration filter until August 2017 and the reference list of eligible studies was screened. The association of each polymorphism with DN was examined using odds ratio and its 95% confidence interval based on dominant, recessive and allele models. Subgroup analyses were conducted based on region, DN definition and DM duration. Results: In the main analysis, the ACE I/D (all models) and AGTR1 A1166C (dominant model) showed a significant association with DN. The main analysis of the AGT M235T polymorphism did not yield significant findings. There were significant subgroup differences and indication of significantly higher odds for DN in terms of DM duration (≥10 years) for ACE I/D (all models), AGT M235T (recessive and allele models) and AGTR1 A1166C (recessive model). Significant subgroup differences were also observed for DN definition (advanced DN group) and region (South Asia) for AGTR1 A1166C (recessive model). Conclusion: In the Asian populations, ACE I/D and AGTR1 A1166C may contribute to DN susceptibility in patients with T2DM by different genetic models. However, the role of AGT M235T needs to be further evaluated.

Original languageEnglish
Pages (from-to)263-276
Number of pages14
JournalCurrent Diabetes Reviews
Volume15
Issue number4
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Diabetic Nephropathies
Meta-Analysis
Angiotensin Type 1 Receptor
Angiotensinogen
Peptidyl-Dipeptidase A
Population
Genes
Alleles
Genetic Models
Renin-Angiotensin System
PubMed
Type 2 Diabetes Mellitus
Odds Ratio
Databases
Confidence Intervals

Keywords

  • ACE I/D
  • AGT M235T
  • AGTR1 A1166C
  • Asian
  • Diabetic nephropathy
  • Renin-angiotensinaldosterone system
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{af678f3f53eb49aba6025e8481a1a136,
title = "Renin–angiotensin–aldosterone system gene polymorphisms and type 2 diabetic nephropathy in asian populations: An updated meta-analysis",
abstract = "Background: The association of polymorphisms in the renin-angiotensin-aldosterone system candidate genes, namely Angiotensin-Converting Enzyme (ACE) Insertion/Deletion (I/D), Angiotensinogen (AGT) M235T and Angiotensin II Receptor Type 1 (AGTR1) A1166C with Diabetic Nephropathy (DN) has been studied for decades. Objective: This meta-analysis aimed to assess the updated pooled effects of these polymorphisms with DN among Asian populations with type 2 diabetes mellitus. Methods: The PubMed electronic database was searched without duration filter until August 2017 and the reference list of eligible studies was screened. The association of each polymorphism with DN was examined using odds ratio and its 95{\%} confidence interval based on dominant, recessive and allele models. Subgroup analyses were conducted based on region, DN definition and DM duration. Results: In the main analysis, the ACE I/D (all models) and AGTR1 A1166C (dominant model) showed a significant association with DN. The main analysis of the AGT M235T polymorphism did not yield significant findings. There were significant subgroup differences and indication of significantly higher odds for DN in terms of DM duration (≥10 years) for ACE I/D (all models), AGT M235T (recessive and allele models) and AGTR1 A1166C (recessive model). Significant subgroup differences were also observed for DN definition (advanced DN group) and region (South Asia) for AGTR1 A1166C (recessive model). Conclusion: In the Asian populations, ACE I/D and AGTR1 A1166C may contribute to DN susceptibility in patients with T2DM by different genetic models. However, the role of AGT M235T needs to be further evaluated.",
keywords = "ACE I/D, AGT M235T, AGTR1 A1166C, Asian, Diabetic nephropathy, Renin-angiotensinaldosterone system, Type 2 diabetes mellitus",
author = "Norfazilah Ahmad and {A. Jamal}, {A. Rahman} and Shah, {Shamsul Azhar} and {Abdul Gafor}, {Abdul Halim} and {Abdul Murad}, {Nor Azian}",
year = "2019",
month = "1",
day = "1",
doi = "10.2174/1573399814666180709100411",
language = "English",
volume = "15",
pages = "263--276",
journal = "Current Diabetes Reviews",
issn = "1573-3998",
publisher = "Bentham Science Publishers B.V.",
number = "4",

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TY - JOUR

T1 - Renin–angiotensin–aldosterone system gene polymorphisms and type 2 diabetic nephropathy in asian populations

T2 - An updated meta-analysis

AU - Ahmad, Norfazilah

AU - A. Jamal, A. Rahman

AU - Shah, Shamsul Azhar

AU - Abdul Gafor, Abdul Halim

AU - Abdul Murad, Nor Azian

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The association of polymorphisms in the renin-angiotensin-aldosterone system candidate genes, namely Angiotensin-Converting Enzyme (ACE) Insertion/Deletion (I/D), Angiotensinogen (AGT) M235T and Angiotensin II Receptor Type 1 (AGTR1) A1166C with Diabetic Nephropathy (DN) has been studied for decades. Objective: This meta-analysis aimed to assess the updated pooled effects of these polymorphisms with DN among Asian populations with type 2 diabetes mellitus. Methods: The PubMed electronic database was searched without duration filter until August 2017 and the reference list of eligible studies was screened. The association of each polymorphism with DN was examined using odds ratio and its 95% confidence interval based on dominant, recessive and allele models. Subgroup analyses were conducted based on region, DN definition and DM duration. Results: In the main analysis, the ACE I/D (all models) and AGTR1 A1166C (dominant model) showed a significant association with DN. The main analysis of the AGT M235T polymorphism did not yield significant findings. There were significant subgroup differences and indication of significantly higher odds for DN in terms of DM duration (≥10 years) for ACE I/D (all models), AGT M235T (recessive and allele models) and AGTR1 A1166C (recessive model). Significant subgroup differences were also observed for DN definition (advanced DN group) and region (South Asia) for AGTR1 A1166C (recessive model). Conclusion: In the Asian populations, ACE I/D and AGTR1 A1166C may contribute to DN susceptibility in patients with T2DM by different genetic models. However, the role of AGT M235T needs to be further evaluated.

AB - Background: The association of polymorphisms in the renin-angiotensin-aldosterone system candidate genes, namely Angiotensin-Converting Enzyme (ACE) Insertion/Deletion (I/D), Angiotensinogen (AGT) M235T and Angiotensin II Receptor Type 1 (AGTR1) A1166C with Diabetic Nephropathy (DN) has been studied for decades. Objective: This meta-analysis aimed to assess the updated pooled effects of these polymorphisms with DN among Asian populations with type 2 diabetes mellitus. Methods: The PubMed electronic database was searched without duration filter until August 2017 and the reference list of eligible studies was screened. The association of each polymorphism with DN was examined using odds ratio and its 95% confidence interval based on dominant, recessive and allele models. Subgroup analyses were conducted based on region, DN definition and DM duration. Results: In the main analysis, the ACE I/D (all models) and AGTR1 A1166C (dominant model) showed a significant association with DN. The main analysis of the AGT M235T polymorphism did not yield significant findings. There were significant subgroup differences and indication of significantly higher odds for DN in terms of DM duration (≥10 years) for ACE I/D (all models), AGT M235T (recessive and allele models) and AGTR1 A1166C (recessive model). Significant subgroup differences were also observed for DN definition (advanced DN group) and region (South Asia) for AGTR1 A1166C (recessive model). Conclusion: In the Asian populations, ACE I/D and AGTR1 A1166C may contribute to DN susceptibility in patients with T2DM by different genetic models. However, the role of AGT M235T needs to be further evaluated.

KW - ACE I/D

KW - AGT M235T

KW - AGTR1 A1166C

KW - Asian

KW - Diabetic nephropathy

KW - Renin-angiotensinaldosterone system

KW - Type 2 diabetes mellitus

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U2 - 10.2174/1573399814666180709100411

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M3 - Article

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AN - SCOPUS:85068806850

VL - 15

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EP - 276

JO - Current Diabetes Reviews

JF - Current Diabetes Reviews

SN - 1573-3998

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