Associations of ACE I/D, AGT M235T gene polymorphisms with pregnancy induced hypertension in Chinese population: a meta-analysis

J Assist Reprod Genet. 2012 Sep;29(9):921-32. doi: 10.1007/s10815-012-9800-4. Epub 2012 May 30.


Purpose: There have been many studies concerning the associations of angiotensin-converting enzyme (ACE) I/D, angiotensinogen (AGT) M235T polymorphisms with pregnancy induced hypertension (PIH) among Chinese populations. However, the results were inconsistent, prompting the necessity of meta-analysis.

Methods: Studies published in English and Chinese were mainly searched in EMbase, PubMed and CBM up to January 2012.

Results: Twenty-three studies with 3,551 subjects for ACE I/D and seven studies with 1,296 subjects for AGT M235T were included. Significant associations were found between ACE I/D and PIH under dominant, recessive and allelic models. A separate analysis confined to preeclampsia suggested that ACE I/D was associated with preeclampsia under recessive model and allelic model, but not dominant model. Stratified analyses were conducted as meta-regression analysis indicated that the sample size of case group was a significant source of heterogeneity, which suggested no significant association between ACE I/D and PIH in the subgroup of more than 100 cases. Associations were found between AGT M235T and PIH under dominant genetic model (OR = 1.59; 95 %CI: 1.04-2.42), recessive genetic model (OR = 1.60; 95 %CI: 1.07-2.40), and allelic model (OR = 1.40; 95 %CI: 1.17-1.68). No publication bias was found in either meta-analysis.

Conclusions: The present meta-analysis suggested significant associations between ACE I/D, AGT M235T and PIH in Chinese populations. However, no significant association was found between ACE I/D and PIH in the subgroup of more than 100 cases. Studies with larger sample sizes are necessary to investigate the associations between gene polymorphisms and PIH in Chinese populations.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alleles
  • Angiotensinogen / genetics*
  • Asian Continental Ancestry Group / genetics*
  • China / epidemiology
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease
  • Genetics, Population
  • Genome-Wide Association Study*
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology
  • Hypertension, Pregnancy-Induced / genetics*
  • Incidence
  • Models, Genetic
  • Peptidyl-Dipeptidase A / genetics*
  • Polymorphism, Genetic*
  • Pregnancy
  • Publication Bias
  • Regression Analysis
  • Sensitivity and Specificity


  • AGT protein, human
  • Angiotensinogen
  • ACE protein, human
  • Peptidyl-Dipeptidase A