Nephrol Dial Transplant (2000) 15: 1008-1013
© 2000 European Renal Association-European Dialysis and Transplant Association
Increased frequency of angiotensin-converting enzyme DD genotype in patients with type 2 diabetes in Taiwan
1 Departments of Internal Medicine and 2 Clinical Pathology, Kaohsiung Medical University, Kaohsiung, Taiwan
Background. Diabetes is one of the major causes of end-stage renal failure in the Taiwanese population. Previous studies have shown that angiotensin-converting enzyme (ACE) inhibitor can improve glucose utilization and suppress hepatic glucose production and the renin–angiotensin system may play an important role in the initiation and progression of diabetic nephropathy. Thus, ACE gene polymorphism may be associated with type 2 diabetes and diabetic nephropathy.
Methods. To investigate the distribution of ACE-I/D genotype in type 2 diabetes and diabetic nephropathy, we examined 336 patients with type 2 diabetes (157 without nephropathy and 179 with nephropathy) and 263 age-matched normal controls. The diagnosis of nephropathy was made when daily protein loss exceeded 500 mg. ACE gene polymorphism was analysed by use of polymerase chain reaction.
Results. Our study revealed that the frequency of the D allele of the ACE gene was 29.3% in normal controls. The frequency of ACE DD genotype was significantly higher in type 2 diabetics compared with normal controls (18.2 vs 9.1%, P<0.01). The frequency of ACE DD genotype in patients with diabetic nephropathy was significantly higher than in patients without nephropathy (22.3 vs 13.4%, P<0.05). To determine whether ACE gene polymorphism was associated with the severity of diabetic nephropathy, we divided patients with diabetic nephropathy into dialysis and non-dialysis groups. The frequency of ACE DD genotype in the dialysis group was significantly higher than in non-dialysis group (28.7 vs 15.3%, P<0.05).
Conclusion. Our results indicate that the frequency of ACE DD genotype is markedly higher in patients with type 2 diabetes, and the ACE DD genotype is significantly associated with diabetic nephropathy.
Keywords: ACE genotype; diabetic nephropathy; type 2 diabetes
Correspondence and offprint requests to: Dr Juei-Hsiung Tsai, Department of Internal Medicine Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung, 80317, Taiwan.
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