Association between the Insertion/Deletion Polymorphism of ACE Gene and Athlete's Sport Performance in Endurance Sports: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 AIJin-wei ^1,2 , LIUYing ² , LIDe-sheng ² , LIUYu ² ,  PEIBin ^1,2

1. Evidence-Based Medicine Center, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, China;
2. Department of Micro-orthopedic Surgery, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, China;

Corresponding?author：

PEIBin, Email: xyxzyxzx@163.com

Keywords：

Peptidyl-dipeptidase A; Polymorphism; Athlete; Endurance sports; Meta-analysis

DOI：

10.7507/1672-2531.20160062

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the association between the insertion/deletion (I/D) polymorphism of angiotension-converting enzyme (ACE) gene and the athletes' performance in endurance sports. Methods Databases including PubMed, EMbase, CNKI, CBM, VIP, and WanFang Data were searched up to August 1^st, 2015 to collect case-control studies about the association between ACE I/D polymorphism and the athletes' performance in endurance sports. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 37 case-control studies involving 3 032 athletes and 10 857 controls were included. The results of meta-analysis showed that significant association was found between ACE I/D polymorphism and the athletes' performance in endurance sports (DD+DI vs. Ⅱ: OR=0.75, 95%CI 0.67 to 0.83, P<0.01; DD vs. Ⅱ: OR=0.73, 95%CI 0.61 to 0.87, P<0.01; DI vs. Ⅱ: OR=0.74, 95%CI 0.66 to 0.83, P<0.01; D vs. Ⅰ: OR=0.85, 95%CI 0.77 to 0.94, P<0.01). Specifically, the ACE I/D polymorphism was significantly associated with the performance of male athletes in endurance sports (DD+DI vs. Ⅱ: OR=0.73, 95%CI 0.61 to 0.88, P<0.01; DD vs. Ⅱ: OR=0.75, 95%CI 0.60 to 0.93, P=0.01; DI vs. Ⅱ: OR=0.70, 95%CI 0.60 to 0.93, P<0.01; D vs. Ⅰ: OR=0.87, 95%CI 0.77 to 0.97, P=0.01). Subgroup analysis of ethnicity showed that, in Caucasians, except for genetic model DD vs. DI+Ⅱ, the other 4 genetic models were significantly associated with the athletes' performance in endurance sports (DD+DI vs. Ⅱ: OR=0.74, 95%CI 0.65 to 0.84, P<0.01; DD vs. Ⅱ: OR=0.72, 95%CI 0.58 to 0.90, P<0.01; DI vs. Ⅱ: OR=0.73, 95%CI 0.64 to 0.84, P<0.01; D vs. Ⅰ: OR=0.87, 95%CI 0.81 to 0.94, P<0.01); in Africans, significant associations with the athletes' performance in endurance sports were found in genetic model DD vs. DI+Ⅱ (OR=0.75, 95%CI 0.57 to 0.98, P=0.04), genetic model DD vs. Ⅱ (OR=0.62, 95%CI 0.42 to 0.92, P=0.02), and genetic model D vs. Ⅰ (OR=0.80, 95%CI 0.66 to 0.96, P=0.02); in Asians, no significant association was found between ACE I/D polymorphism and the performance of athletes of difference races in endurance sports. Conclusion Current evidence indicates that the ACE I/D polymorphism may be associated with the performance of athletes especially male athletes and the Caucasian subgroup in endurance sports. ACE allele D is negatively associated with the athletes' performance in endurance sports, while allele I is positively associated with the athletes' performance in endurance sports. Due to the quality limitations of included studies, more high quality case-control or cohort studies are needed to verify the above conclusions.

Citation： AIJin-wei, LIUYing, LIDe-sheng, LIUYu, PEIBin. Association between the Insertion/Deletion Polymorphism of ACE Gene and Athlete's Sport Performance in Endurance Sports: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 392-402. doi: 10.7507/1672-2531.20160062 Copy

1.	鄧文騫, 王璐, 左天香, 等. 耐力素質與力量素質相關基因的研究進展. 四川體育科學, 2007, 4(1):34-37.
2.	楊若愚, 王予彬, 沈勛章, 等. 基因多態性與杰出運動能力. 中國組織工程研究, 2014, 18(7):1121-1128.
3.	Payne J, Montgomery H. Genetic variation and physical performance. World Rev Nutr Diet, 2004, 93:270-302.
4.	左彥方, 龍愛梅, 黃曉青, 等. 血管緊張素轉換酶基因多態性與2型糖尿病腎病相關性的Meta分析. 中國循證醫學雜志, 2012, 12(9):1071-1075.
5.	吳曉梅, 時玥, 時景璞. 中國漢族人群腦出血患者血管緊張素轉換酶基因插入/缺失多態性的Meta分析. 中國循證醫學雜志, 2009, 9(12):1323-1327.
6.	Gayagay G, Yu B, Hambly B, et al. Elite endurance athletes and the ACE Ⅰ allele——the role of genes in athletic performance. Hum Genet, 1998, 103(1):48-50.
7.	Hagberg J, Rankinen T, Loos R, et al. Advances in exercise, fitness, and performance genomics in 2010. Med Sci Sports Exer, 2011, 43(5):743-752.
8.	Guth LM, Roth SM. Genetic influence on athletic performance. Curr Opin Pediatr, 2013, 25(6):653-658.
9.	楊賢罡, 揚胡. ACE基因I/D多態性與耐力素質的關聯性研究:Meta分析. 體育科學, 2010, 30(7):42-49.
10.	Ma F, Yang Y, Li X, et al. The association of sport performance with ACE and ACTN3 genetic polymorphisms:a systematic review and meta-analysis. PLoS One, 2013, 8(1):e54685.
11.	張明軍, 葉學球. 中國漢族成年運動員ACE基因多態性與運動能力的Meta分析. 惠州學院學報, 2015, 35(3):109-116.
12.	Moher D, Liberati A, Tetzlaff J, et al. Reprint——preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. Phys Ther, 2009, 89(9):873-880.
13.	曾憲濤, 高嶺, 劉得璽, 等. 牙周病與口腔癌相關性的Meta分析. 湖北醫藥學院學報, 2012, 31(05):390-394.
14.	Woods D, Hickman M, Jamshidi Y, et al. Elite swimmers and the D allele of the ACE I/D polymorphism. Hum Genet, 2001, 108(3):230-232.
15.	Papadimitriou ID, Papadopoulos C, Kouvatsi A, et al. The ACE I/D polymorphism in elite Greek track and field athletes. J Sports Med Phys Fitness, 2009, 49(4):459-463.
16.	Shahmoradi S, Ahmadalipour A, Salehi M. Evaluation of ACE gene I/D polymorphism in Iranian elite athletes. Adv Biomed Res, 2014, 3(1):207-213.
17.	Costa A, Silva A, Garrido N, et al. Association between ACE D allele and elite short distance swimming. Eur J Appl Physiol, 2009, 106(6):785-790.
18.	Amir O, Amir R, Yamin C, et al. The ACE deletion allele is associated with Israeli elite endurance athletes. Exp Physiol, 2007, 92(5):881-886.
19.	Gómez-Gallego F, Santiago C, González-Freire G, et al. Endurance performance:genes or gene combinations? Int J Sports Med, 2008, 30(1):66-72.
20.	Tanriverdi H, Evrengul H, Tanriverdi S, et al. Improved endothelium dependent vasodilation in endurance athletes and its relation with ACE I/D polymorphism. Circ J, 2005, 69(9):1105-1110.
21.	Shenoy S, Tandon S, Sandhu J, et al. Association of angiotensin converting enzyme gene polymorphism and Indian army triathletes performance. Asian J Sports Med, 2010, 1(3):143-150.
22.	Ruiz JR, Gómez-Gallego F, Santiago C, et al. Is there an optimum endurance polygenic profile? J Physiol, 2009, 587(7):1527-1534.
23.	Scanavini D, Bernardi F, Castoldi E, et al. Increased frequency of the homozygous Ⅱ ACE genotype in Italian Olympic endurance athletes. Eur J Hum Genet, 2002, 10(10):576-577.
24.	Alvarez R, Terrados N, Ortolano R, et al. Genetic variation in the renin-angiotensin system and athletic performance. Eur J Appl Physiol, 2000, 82(1):117-120.
25.	Cieszczyk P, Krupecki K, Maciejewska A, et al. The angiotensin converting enzyme gene I/D polymorphism in Polish rowers. Int J Sports Med, 2009, 30(8):624-627.
26.	Lucia A, Gómez-Gallego F, Chicharro JL, et al. Is there an association between ACE and CKMM polymorphisms and cycling performance status during 3-week races? Intl J Sports Med, 2005, 26(6):442-447.
27.	Myerson S, Hemingway H, Budget R, et al. Human angiotensin I-converting enzyme gene and endurance performance. J Appl Phycol, 1999, 87(4):1313-1316.
28.	Nazarov IB, Woods DR, Montgomery HE, et al. The angiotensin converting enzyme I/D polymorphism in Russian athletes. Eur J Hum Genet, 2001, 9(10):797-801.
29.	Wang G, Mikami E, Chiu LL, et al. Association analysis of ACE and ACTN3 in elite Caucasian and East Asian swimmers. Med Sci Sports Exerc, 2013, 45(5):892-900.
30.	Juffer P, Furrer R, González-Freire M, et al. Genotype distributions in top-level soccer players:a role for ACE? Int J Sports Med, 2009, 30(5):387-392.
31.	Ginevi?ien? V, Pranculis A, Jakaitien? A, et al. Genetic variation of the human ACE and ACTN3 genes and their association with functional muscle properties in Lithuanian elite athletes. Medicina (Kaunas), 2011, 47(5):284-290.
32.	Ruiz JR, Arteta D, Buxens A, et al. Can we identify a power-oriented polygenic profile? J Appl Physiol, 2010, 108(3):561-566.
33.	Drozdovska SB, Dosenko VE, Ahmetov Ⅱ, et al. The association of gene polymorphisms with athlete status in Ukrainians. Biol Sport, 2013, 30(3):163-167.
34.	Muniesa CA, González-Freire M, Santiago C, et al. World-class performance in lightweight rowing:is it genetically influenced? A comparison with cyclists, runners and non-athletes. Br J Sports Med, 2010, 44(12):898-901.
35.	Grenda A, Leońska-Duniec A, Kaczmarczyk M, et al. Interaction between ACE I/D and ACTN3 R557X polymorphisms in Polish competitive swimmers. J Hum Kinet, 2014, 42(1):127-136.
36.	Taylor RR, Mamotte CD, Fallon K, et al. Elite athletes and the gene for angiotensin-converting enzyme. J Appl Physiol, 1999, 87(3):1035-1037.
37.	Rankinen T, Wolfarth B, Simoneau JA, et al. No association between the angiotensin-converting enzyme ID polymorphism and elite endurance athlete status. J Appl Physiol, 2000, 88:1571-1575.
38.	Hruskovicová H, Dzurenková D, Selingerová M, et al. The angiotensin converting enzyme I/D polymorphism in long distance runners. J Sports Med Phys Fitness, 2006, 46(3):509-513.
39.	Scott RA, Moran C, Wilson RH, et al. No association between angiotensin converting enzyme (ACE) gene variation and endurance athlete status in Kenyans. Comp Biochem Physiol A Mol Integr Physiol, 2005, 141(2):169-175.
40.	Ash GI, Scott RA, Deason M, et al. No Association between ACE Gene Variation and Endurance Athlete Status in Ethiopians. Med Sci Sports Exerc, 2011, 43(4):590-597.
41.	Collins M, Xenophontos SL, Carioliu MA, et al. The ACE Gene and Endurance Performance during the South African Ironman Triathlons. Med Sci Sports Exerc, 2004, 36(8):1314-1320.
42.	孫小敏, 甄文娟, 王煜, 等. 運動員血管緊張素轉換酶基因插入或缺失多態性研究. 中國運動醫學雜志, 2004, 23(5):546-547.
43.	李麗, 韓偉, 于英君. ACE基因I/D多態性與中國越野滑雪運動員運動能力的相關性研究. 冰雪運動, 2012, 34(1):54-58.
44.	席翼, 張秀麗, 胡揚, 等. 中國優秀馬拉松運動員ACE基因I/D多態性頻率分布特征. 中國運動醫學雜志, 2006, 25(4):391-394.
45.	王國元, 何恩鵬, 阿布都克依木·熱合曼. 新疆維吾爾族運動員ACE基因I/D多態與有氧運動能力關聯研究. 西安體育學院學報, 2009, 26(2):214-218.
46.	于瀅, 李云廣. 我國優秀冬季項目運動員ACE基因I/D多態分布研究. 哈爾濱體育學院學報, 2013, 31(5):13-16.
47.	李麗, 畢鵬輝, 趙玉華, 等. 我國技能主導類優秀滑雪運動員ACE基因I/D多態性與運動能力的相關性分析. 南京體育學院學報(自然科學版), 2014, 13(5):18-21.
48.	高炳宏, 陳佩杰, 董強剛, 等. 上海地區漢族優秀游泳運動員ACE基因I/D多態性研究. 中國運動醫學雜志, 2006, 25(5):517-521.
49.	Tobina T, Michishita R, Yamasawa F, et al. Association between the angiotensin I-converting enzyme gene insertion/deletion polymorphism and endurance running speed in Japanese runners. J Physiol Sci, 2010, 60(5):325-330.
50.	Puthucheary Z, Skipworth JR, Rawal J, et al. The ACE gene and human performance:12 years on. Sports Med, 2011, 41(6):433-448.
51.	Woods DR, Humphries SE, Montgomery HE. The ACE I/D Polymorphism and Human Physical Performance. Trends Endocrinol Metab, 2000, 11(10):416-420.
52.	Rankinen T, Roth SM, Bray MS, et al. Advances in exercise, fitness, and performance genomics. Med Sci Sports Exerc, 2010, 42(5):835-846.
53.	Moore TY, Biewener AA. Outrun or outmaneuver:predator-prey interactions as a model system for integrating biomechanical studies in a broader ecological and evolutionary context. Integr Comp Biol, 2015, 55(6):1188-1197.
54.	Hagberg JM, Moore GE, Ferrell RE. Specific genetic markers of endurance performance and V.O₂max. Exerc Sport Sci Rev, 2011, 29(1):15-19.

1. 鄧文騫, 王璐, 左天香, 等. 耐力素質與力量素質相關基因的研究進展. 四川體育科學, 2007, 4(1):34-37.
2. 楊若愚, 王予彬, 沈勛章, 等. 基因多態性與杰出運動能力. 中國組織工程研究, 2014, 18(7):1121-1128.
3. Payne J, Montgomery H. Genetic variation and physical performance. World Rev Nutr Diet, 2004, 93:270-302.
4. 左彥方, 龍愛梅, 黃曉青, 等. 血管緊張素轉換酶基因多態性與2型糖尿病腎病相關性的Meta分析. 中國循證醫學雜志, 2012, 12(9):1071-1075.
5. 吳曉梅, 時玥, 時景璞. 中國漢族人群腦出血患者血管緊張素轉換酶基因插入/缺失多態性的Meta分析. 中國循證醫學雜志, 2009, 9(12):1323-1327.
6. Gayagay G, Yu B, Hambly B, et al. Elite endurance athletes and the ACE Ⅰ allele——the role of genes in athletic performance. Hum Genet, 1998, 103(1):48-50.
7. Hagberg J, Rankinen T, Loos R, et al. Advances in exercise, fitness, and performance genomics in 2010. Med Sci Sports Exer, 2011, 43(5):743-752.
8. Guth LM, Roth SM. Genetic influence on athletic performance. Curr Opin Pediatr, 2013, 25(6):653-658.
9. 楊賢罡, 揚胡. ACE基因I/D多態性與耐力素質的關聯性研究:Meta分析. 體育科學, 2010, 30(7):42-49.
10. Ma F, Yang Y, Li X, et al. The association of sport performance with ACE and ACTN3 genetic polymorphisms:a systematic review and meta-analysis. PLoS One, 2013, 8(1):e54685.
11. 張明軍, 葉學球. 中國漢族成年運動員ACE基因多態性與運動能力的Meta分析. 惠州學院學報, 2015, 35(3):109-116.
12. Moher D, Liberati A, Tetzlaff J, et al. Reprint——preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. Phys Ther, 2009, 89(9):873-880.
13. 曾憲濤, 高嶺, 劉得璽, 等. 牙周病與口腔癌相關性的Meta分析. 湖北醫藥學院學報, 2012, 31(05):390-394.
14. Woods D, Hickman M, Jamshidi Y, et al. Elite swimmers and the D allele of the ACE I/D polymorphism. Hum Genet, 2001, 108(3):230-232.
15. Papadimitriou ID, Papadopoulos C, Kouvatsi A, et al. The ACE I/D polymorphism in elite Greek track and field athletes. J Sports Med Phys Fitness, 2009, 49(4):459-463.
16. Shahmoradi S, Ahmadalipour A, Salehi M. Evaluation of ACE gene I/D polymorphism in Iranian elite athletes. Adv Biomed Res, 2014, 3(1):207-213.
17. Costa A, Silva A, Garrido N, et al. Association between ACE D allele and elite short distance swimming. Eur J Appl Physiol, 2009, 106(6):785-790.
18. Amir O, Amir R, Yamin C, et al. The ACE deletion allele is associated with Israeli elite endurance athletes. Exp Physiol, 2007, 92(5):881-886.
19. Gómez-Gallego F, Santiago C, González-Freire G, et al. Endurance performance:genes or gene combinations? Int J Sports Med, 2008, 30(1):66-72.
20. Tanriverdi H, Evrengul H, Tanriverdi S, et al. Improved endothelium dependent vasodilation in endurance athletes and its relation with ACE I/D polymorphism. Circ J, 2005, 69(9):1105-1110.
21. Shenoy S, Tandon S, Sandhu J, et al. Association of angiotensin converting enzyme gene polymorphism and Indian army triathletes performance. Asian J Sports Med, 2010, 1(3):143-150.
22. Ruiz JR, Gómez-Gallego F, Santiago C, et al. Is there an optimum endurance polygenic profile? J Physiol, 2009, 587(7):1527-1534.
23. Scanavini D, Bernardi F, Castoldi E, et al. Increased frequency of the homozygous Ⅱ ACE genotype in Italian Olympic endurance athletes. Eur J Hum Genet, 2002, 10(10):576-577.
24. Alvarez R, Terrados N, Ortolano R, et al. Genetic variation in the renin-angiotensin system and athletic performance. Eur J Appl Physiol, 2000, 82(1):117-120.
25. Cieszczyk P, Krupecki K, Maciejewska A, et al. The angiotensin converting enzyme gene I/D polymorphism in Polish rowers. Int J Sports Med, 2009, 30(8):624-627.
26. Lucia A, Gómez-Gallego F, Chicharro JL, et al. Is there an association between ACE and CKMM polymorphisms and cycling performance status during 3-week races? Intl J Sports Med, 2005, 26(6):442-447.
27. Myerson S, Hemingway H, Budget R, et al. Human angiotensin I-converting enzyme gene and endurance performance. J Appl Phycol, 1999, 87(4):1313-1316.
28. Nazarov IB, Woods DR, Montgomery HE, et al. The angiotensin converting enzyme I/D polymorphism in Russian athletes. Eur J Hum Genet, 2001, 9(10):797-801.
29. Wang G, Mikami E, Chiu LL, et al. Association analysis of ACE and ACTN3 in elite Caucasian and East Asian swimmers. Med Sci Sports Exerc, 2013, 45(5):892-900.
30. Juffer P, Furrer R, González-Freire M, et al. Genotype distributions in top-level soccer players:a role for ACE? Int J Sports Med, 2009, 30(5):387-392.
31. Ginevi?ien? V, Pranculis A, Jakaitien? A, et al. Genetic variation of the human ACE and ACTN3 genes and their association with functional muscle properties in Lithuanian elite athletes. Medicina (Kaunas), 2011, 47(5):284-290.
32. Ruiz JR, Arteta D, Buxens A, et al. Can we identify a power-oriented polygenic profile? J Appl Physiol, 2010, 108(3):561-566.
33. Drozdovska SB, Dosenko VE, Ahmetov Ⅱ, et al. The association of gene polymorphisms with athlete status in Ukrainians. Biol Sport, 2013, 30(3):163-167.
34. Muniesa CA, González-Freire M, Santiago C, et al. World-class performance in lightweight rowing:is it genetically influenced? A comparison with cyclists, runners and non-athletes. Br J Sports Med, 2010, 44(12):898-901.
35. Grenda A, Leońska-Duniec A, Kaczmarczyk M, et al. Interaction between ACE I/D and ACTN3 R557X polymorphisms in Polish competitive swimmers. J Hum Kinet, 2014, 42(1):127-136.
36. Taylor RR, Mamotte CD, Fallon K, et al. Elite athletes and the gene for angiotensin-converting enzyme. J Appl Physiol, 1999, 87(3):1035-1037.
37. Rankinen T, Wolfarth B, Simoneau JA, et al. No association between the angiotensin-converting enzyme ID polymorphism and elite endurance athlete status. J Appl Physiol, 2000, 88:1571-1575.
38. Hruskovicová H, Dzurenková D, Selingerová M, et al. The angiotensin converting enzyme I/D polymorphism in long distance runners. J Sports Med Phys Fitness, 2006, 46(3):509-513.
39. Scott RA, Moran C, Wilson RH, et al. No association between angiotensin converting enzyme (ACE) gene variation and endurance athlete status in Kenyans. Comp Biochem Physiol A Mol Integr Physiol, 2005, 141(2):169-175.
40. Ash GI, Scott RA, Deason M, et al. No Association between ACE Gene Variation and Endurance Athlete Status in Ethiopians. Med Sci Sports Exerc, 2011, 43(4):590-597.
41. Collins M, Xenophontos SL, Carioliu MA, et al. The ACE Gene and Endurance Performance during the South African Ironman Triathlons. Med Sci Sports Exerc, 2004, 36(8):1314-1320.
42. 孫小敏, 甄文娟, 王煜, 等. 運動員血管緊張素轉換酶基因插入或缺失多態性研究. 中國運動醫學雜志, 2004, 23(5):546-547.
43. 李麗, 韓偉, 于英君. ACE基因I/D多態性與中國越野滑雪運動員運動能力的相關性研究. 冰雪運動, 2012, 34(1):54-58.
44. 席翼, 張秀麗, 胡揚, 等. 中國優秀馬拉松運動員ACE基因I/D多態性頻率分布特征. 中國運動醫學雜志, 2006, 25(4):391-394.
45. 王國元, 何恩鵬, 阿布都克依木·熱合曼. 新疆維吾爾族運動員ACE基因I/D多態與有氧運動能力關聯研究. 西安體育學院學報, 2009, 26(2):214-218.
46. 于瀅, 李云廣. 我國優秀冬季項目運動員ACE基因I/D多態分布研究. 哈爾濱體育學院學報, 2013, 31(5):13-16.
47. 李麗, 畢鵬輝, 趙玉華, 等. 我國技能主導類優秀滑雪運動員ACE基因I/D多態性與運動能力的相關性分析. 南京體育學院學報(自然科學版), 2014, 13(5):18-21.
48. 高炳宏, 陳佩杰, 董強剛, 等. 上海地區漢族優秀游泳運動員ACE基因I/D多態性研究. 中國運動醫學雜志, 2006, 25(5):517-521.
49. Tobina T, Michishita R, Yamasawa F, et al. Association between the angiotensin I-converting enzyme gene insertion/deletion polymorphism and endurance running speed in Japanese runners. J Physiol Sci, 2010, 60(5):325-330.
50. Puthucheary Z, Skipworth JR, Rawal J, et al. The ACE gene and human performance:12 years on. Sports Med, 2011, 41(6):433-448.
51. Woods DR, Humphries SE, Montgomery HE. The ACE I/D Polymorphism and Human Physical Performance. Trends Endocrinol Metab, 2000, 11(10):416-420.
52. Rankinen T, Roth SM, Bray MS, et al. Advances in exercise, fitness, and performance genomics. Med Sci Sports Exerc, 2010, 42(5):835-846.
53. Moore TY, Biewener AA. Outrun or outmaneuver:predator-prey interactions as a model system for integrating biomechanical studies in a broader ecological and evolutionary context. Integr Comp Biol, 2015, 55(6):1188-1197.
54. Hagberg JM, Moore GE, Ferrell RE. Specific genetic markers of endurance performance and V.O₂max. Exerc Sport Sci Rev, 2011, 29(1):15-19.

Chinese Journal of Evidence-Based Medicine

Association between the Insertion/Deletion Polymorphism of ACE Gene and Athlete's Sport Performance in Endurance Sports: A Meta-analysis

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