Relationship between angiotensin-converting enzyme gene polymorphism and insulin resistance in never-treated hypertensive patients.
The association between angiotensin-converting enzyme (ACE) gene polymorphism and insulin resistance (IR) in hypertensive subjects remains controversial. Thus, we evaluated the possible association between IR and ACE gene polymorphism in a group of hypertensive, never-treated patients compared with that in a normotensive control group. We enrolled 200 (114 men and 86 women; age, 45.5 +/- 4.7 yr) hypertensive patients and 96 (54 men and 42 women; age, 44.0 +/- 4.7 yr) normotensive subjects. A double PCR assay was used to identify ACE genotypes. We determined fasting glucose and insulin by the glucose oxidase method and using a standard RIA technique. IR was estimated using the homeostasis model assessment (HOMA(IR)). Both fasting glucose (5.0 +/- 0.3 vs. 4.7 +/- 0.3 mmol/L; P < 0.0001), insulin levels (12.3 +/- 4.7 vs. 4.9 +/- 1.5 muU/mL; P < 0.0001), and HOMA(IR) (2.7 +/- 1.1 vs. 1.1 +/- 0.3; P < 0.0001) were significantly higher in hypertensive patients than in the normotensive control group. When we subdivided hypertensive patients according to ACE genotype, we observed that fasting insulin and HOMA(IR) were 16.3 +/- 3.3 and 3.6 +/- 0.8 in the DD genotype, 9.4 +/- 3.1 and 2.1 +/- 0.7 in the ID genotype, and 8.3 +/- 2.8 and 1.9 +/- 0.7 muU/mL in the II group (P < 0.0001, by ANOVA). No significant differences were observed in the normotensive control group. In conclusion, we extended previous data regarding the relationship of hypertension and IR by demonstrating a dependence of this relationship upon the ACE gene polymorphism.
Cardiovascular Diseases Unit, Clinical Pathology Laboratory, Department of Medicina Sperimentale e Clinica G. Salvatore, University of Catanzaro, Magna Graecia, 88100 Catanzaro, Italy. perticone@unicz.it
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Perticone
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Ceravolo
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Iacopino
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Cloro
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Ventura
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Maio
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Gulletta
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Perrotti
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Mattioli
D000328:Adult; D000483:Alleles; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000235:genetics / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012016:Reference Values
D001786:Blood Glucose; D007328:Insulin; D007703:Peptidyl-Dipeptidase A