Relationship of angiotensin-converting enzyme gene polymorphism with nephropathy associated with Type 2 diabetes mellitus in Asian Indians.
OBJECTIVE
Diabetic nephropathy (DN) has become the leading cause of end-stage renal disease, but the pathogenesis of this condition is not exactly understood. Several studies from different parts of the world have examined angiotensin-converting enzyme (ACE) gene polymorphism as a candidate for DN. Two studies yielding controversial results have been reported from India. To rule out this discrepancy, we carried out a hospital-based study on a cohort from our population to determine whether ACE gene polymorphism is associated with DN.


METHODS
ACE gene polymorphism was analyzed by polymerase chain reaction in 460 individuals consisting of 174 cases of DN, 175 cases of Type 2 diabetes mellitus (DM), and 111 controls. The DN cases included in the study were Type 2 DM cases with serum creatinine >1.5 mg/dl and serum albumin >30 mg/dl in a 24-h urine sample.


RESULTS
ACE insertion/deletion genotyping analysis showed DD genotype in 22.75% of DN cases, 15.42% of Type 2 DM cases, and 21.62% of controls. Chi-square test between the DN group and the control group did not show a significant difference in D allele. However, the difference was significant at P<.05 between the DN group and the DM group. The odds ratio was 2.0953 (95% confidence interval=1.35-3.2522), indicating a significant association of DD genotype and D allele with DN.


CONCLUSIONS
Our data enable us to conclude that Asian Indians with D allele and Type 2 DM are at greater risk for developing DN.
Movva
Sireesha
S
Department of Genetics, Bhagwan Mahavir Hospital and Research Center, A.C. Guards, Hyderabad 500004, India.
Alluri
Ravindra V
RV
Komandur
Sreelatha
S
Vattam
Kiran
K
Eppa
Kavitha
K
Mukkavali
Kamal K
KK
Mubigonda
Somashekhar
S
Saharia
Sarbeshwar
S
Shastry
Jandayala C
JC
Hasan
Qurratulain
Q
D000328:Adult; D000483:Alleles; D001208:Asia / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000201:enzymology / Q000453:epidemiology / Q000235:genetics*; D003928:Diabetic Nephropathies / Q000201:enzymology / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005838:Genotype; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics* / Q000378:metabolism; D011110:Polymorphism, Genetic / Q000235:genetics*
D007703:Peptidyl-Dipeptidase A