ACE genotype, body weight changes and target organ damage in renal transplant recipients.
BACKGROUND
Carriage of the angiotensin-converting enzyme (ACE) D-allele favors weight gain in mid-life and, possibly, cardiovascular complications; we aimed to verify the relationship between these conditions and ACE polymorphisms in the renal transplant (RTx) setting.


METHODS
ACE genotypes were evaluated in 169 RTx recipients (107 males, 62 females) and related to body mass index (BMI; kg/m2) changes 1 year after transplant, as well as to cardiovascular events and allograft loss. Allelic frequencies and body weights were compared with those of a control group (age- and sex-matched healthy blood donors).


RESULTS
Allelic frequencies were 0.639 and 0.669 for the D-allele, and 0.361 and 0.331 for the I-allele, in recipients and controls, respectively (p=NS). In the patient population, carriage of the I/ allele was associated with a BMI >23 at the time of RTx (p<0.005). In contrast, in the control group, higher BMI values tended to occur in D/ carriers. Moreover, BMI values were higher in the control group (24.7 -/+ 3.5 vs. 23.6 -/+ 3.3, p=0.003) but, 1 year after RTx, this difference was nullified. At multivariate analysis, the factors associated with weight gain after RTx were ACE D/D (odds ratio [OR] = 2.35, 95% confidence interval [95% CI], 1.00-5.49) and age at RTx <or=49 years (OR=2.82, 95% CI, 1.30-6.13); the factors associated with cardiovascular events and/or allograft loss were cyclosporine-based immunosuppressive regimen (p=0.002), history of smoking (p=0.005) and dyslipidemia (p<0.05).


CONCLUSIONS
Body weight at the time of RTx and weight gain 1 year after RTx, but not cardiovascular complications and allograft loss, are related to the ACE I/D genotype of RTx recipients.
Stratta
Piero
P
Department of Clinical and Experimental Medicine, University of Eastern Piedmont "A. Avogadro", Novara, Italy.
Smirne
Carlo
C
Fangazio
Stefano
S
Cornella
Cristina
C
Lazzarich
Elisa
E
Minisini
Rosalba
R
Toniutto
Pierluigi
P
Fabris
Carlo
C
Barbé
Cristina
C
Pirisi
Mario
M
D000328:Adult; D000368:Aged; D000483:Alleles; D004247:DNA / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D005838:Genotype; D006085:Graft Survival / Q000235:genetics; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics* / Q000378:metabolism; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D015430:Weight Gain / Q000235:genetics*; D055815:Young Adult
D004247:DNA; D007703:Peptidyl-Dipeptidase A