[I/D polymorphism of angiotensin I converting enzyme gene and arterial hypertension in patients with type 2 diabetes mellitus].
Type 2 diabetes mellitus and arterial hypertension coexist very frequently. About 80% patients with type 2 diabetes suffer for hypertension, which is connected with higher morbidity and mortality from cardiovascular diseases. There are evidences that activation of the renin-angiotensin system (RAS), one of the most potent factors in blood pressure regulation, can decrease insulin sensitivity of tissues. As I/D polymorphism of angiotensin converting enzyme (ACE) gene can influence the activity of RAS, it may also influence both carbohydrate metabolism and blood pressure.


OBJECTIVE
To assess the relationship between the I/D polymorphism of ACE gene and frequency of hypertension and values of blood pressure in type 2 diabetic patients.


METHODS
Examined group: 108 type 2 diabetic patients (38 women and 70 men), with mean duration of disease 9.07 +/- 6.68 years, mean age 59.98 +/- 9.10 years. We assessed following parameters: body mass index (BMI), waist/hip ratio (WHR), arterial blood pressure. Laboratory tests: concentration of the glucose, glycosylated hemoglobin (HbA1c), creatinine and urinary albumin excretion rate (UAER). Insulin resistance was calculated by the HOMA rate. I/D ACE gene polymorphism was evaluated by polymerase chain reaction (PCR).


RESULTS
DD genotype carriers had significant higher systolic and diastolic blood pressure (147.8 +/- 19.8 vs 138.2 +/- 16.5 mm Hg, p = 0.03; 89.2 +/- 9.6 vs 81.7 +/- 8.6 mm Hg p = 0.004; respectively) than II patients. Groups with II, ID and DD genotype were not different in age, BMI, WHR, duration of diabetes, the prevalence and duration of arterial hypertension, degree of metabolic control of diabetes and insulin resistance assessed by HOMA rate.


CONCLUSIONS
In type 2 diabetic patients the DD genotype of ACE gene is not connected with higher prevalence of hypertension, but it is associated with higher systolic and diastolic blood pressure.
Pomorska Akademia Medyczna w Szczecinie, Klinika Diabetologii i Chorób Wewnetrznych. pmoleda@wp.pl
Piotr
P
Moleda
Liliana
L
Majkowska
Krzysztof
K
Safranow
Iwona
I
Goracy
Grazyna
G
Adler
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000201:enzymology* / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D020022:Genetic Predisposition to Disease; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics*; D007333:Insulin Resistance / Q000235:genetics; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics* / Q000378:metabolism; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length; D012084:Renin-Angiotensin System / Q000235:genetics
D006442:Glycated Hemoglobin; D007703:Peptidyl-Dipeptidase A