ACE gene polymorphism as a prognostic indicator in patients with type 2 diabetes and established renal disease.
OBJECTIVE
To investigate whether the DD genotype is a predictor of mortality and of the decline in renal function in patients with type 2 diabetes and established nephropathy.


METHODS
A total of 56 such patients of Maltese Caucasian descent were recruited, and their ACE genotype was determined. Serum creatinine was estimated approximately every 4 months. The glomerular filtration rate (GFR) was calculated according to the Cockroft-Gault formula, and rate of change was determined by regression analysis.


RESULTS
The rate of change in calculated GFR was -7.76 ml.min(-1).year(-1) in those with the DD genotype (n = 31) and -1.17 ml. min(-1). h(-1) in those with the ID or II genotype (n = 25) (P < 0.01). The 3-year mortality was 45.2% in the DD group compared with 20.0% in the ID/II group (P < 0.05).


CONCLUSIONS
The DD genotype of the ACE gene polymorphism is associated with a more rapid decline in renal function and higher mortality in type 2 diabetic patients with established nephropathy.
Fava
S
S
Diabetes Clinic, St. Luke's Hospital, Guardamangia, Malta. sdfava@orbit.net.mt
Azzopardi
J
J
Ellard
S
S
Hattersley
A T
AT
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000201:enzymology / Q000235:genetics* / Q000401:mortality; D003928:Diabetic Nephropathies / Q000201:enzymology / Q000235:genetics* / Q000503:physiopathology; D005260:Female; D005838:Genotype; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D011379:Prognosis; D015996:Survival Rate
D006442:Glycated Hemoglobin; D007703:Peptidyl-Dipeptidase A