title: Circadian blood pressure variation in normotensive type 2 diabetes patients and angiotensin converting enzyme polymorphism.
abstract: OBJECTIVE
  Loss of circadian blood pressure (BP) variation (i.e., lack of nocturnal BP dip by at least 10mmHg, 'non-dipping') is associated with increased mortality rate in subjects with diabetes. We studied whether angiotensin converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism may play a role in 24-h BP rhythm control.
  
  
  METHODS
  The study group was 38 normotensive normoalbuminuric type 2 diabetes patients with impaired BP variation, the controls were 51 well-matched type 2 diabetes subjects with normal 24-h BP rhythm. ACE I/D polymorphism, endothelial function and subclinical inflammation parameters (serum endothelin-1, sE-selectin, intercellular and vascular cell adhesion molecules, tumor necrosis factor-alpha) were assessed.
  
  
  RESULTS
  ACE DD genotype was found in 20 (53%), ID genotype in 16 (42%), and II genotype in 2 (5%) study group subjects, while 5 (10%) control subjects had DD genotype, 30 (59%) - ID genotype, and 16 (31%) - II genotype (p<0.0001). Study group subjects presented with marked endothelial dysfunction.
  
  
  CONCLUSIONS
  Impaired circadian blood pressure variation in normotensive normoalbuminuric type 2 diabetes patients is associated with ACE DD genotype and marked endothelial dysfunction when compared to diabetic subjects with normal blood pressure rhythm.
authors.affiliation: Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland. bigosik@poczta.onet.pl
authors.forename: Leszek
authors.initials: L
authors.lastname: Czupryniak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Młynarski
authors.forename: Maciej
authors.initials: M
authors.lastname: Pawłowski
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Saryusz-Wolska
authors.forename: Anna
authors.initials: A
authors.lastname: Borkowska
authors.forename: Izabela
authors.initials: I
authors.lastname: Klich
authors.forename: Jerzy
authors.initials: J
authors.lastname: Bodalski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Loba
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000201:enzymology / Q000235:genetics* / Q000503:physiopathology*; D003971:Diastole; D019040:E-Selectin / Q000032:analysis; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016254:Mutagenesis, Insertional; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012016:Reference Values; D017384:Sequence Deletion; D013599:Systole; D019010:Vascular Cell Adhesion Molecule-1 / Q000032:analysis
chemical_list: D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D007703:Peptidyl-Dipeptidase A