Angiotensin I converting enzyme gene polymorphism and insulin resistance in patients with angina pectoris.
The association between insertion/deletion polymorphism of the angiotensin I converting enzyme (ACE) gene and insulin resistance (IR) was investigated in 64 consecutive patients (F/M: 11/53) with angina pectoris without clinically manifest diabetes mellitus who underwent diagnostic coronary angiography. The observed frequency distribution of ACE genotypes did not deviate from that predicted from the Hardy-Weinberg equilibrium in this group. Patients with the ACE-ID genotype had significantly lower IR, as assessed by an oral glucose tolerance test (OGTT) and by homeostatic model assessment (HOMA), compared to those with the ACE-II genotype, as assessed by a multiple comparison analysis. Patients were divided into two groups with low and high HOMA-IR, and the I allele was seen more frequently in the high HOMA-IR group than in the low HOMA-IR group (0.62 v 0.47, respectively, by chi2 test, P < .05). Logistic regression analysis showed that the odds ratio for insulin resistance in patients with the II genotype, compared to those with the ID and DD-genotypes (assuming that the I allele has a recessive effect), was 4.0 (95% confidence interval, 1.2 to 16.5; P = .037), after adjusting for the presence of significant coronary atherosclerosis. In conclusion, the D allele was not associated with higher insulin resistance in patients with angina pectoris; that is, patients with the ID and DD genotypes were associated with a significantly lower risk of insulin resistance, compared to those with the II genotype.
Takezako
T
T
Department of Internal Medicine, Fukuoka University School of Medicine, Japan.
Saku
K
K
Zhang
B
B
Ou
J
J
Bai
H
H
Imai
K
K
Jimi
S
S
Shirai
K
K
Arakawa
K
K
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000235:genetics*; D017023:Coronary Angiography; D005260:Female; D005787:Gene Frequency; D006801:Humans; D007333:Insulin Resistance / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012044:Regression Analysis
D007703:Peptidyl-Dipeptidase A