title: High serum ACE activity predicts severe hypoglycaemia over time in patients with type 1 diabetes.
abstract: OBJECTIVE
  High serum angiotensin-converting enzyme (ACE) activity is associated with increased risk of severe hypoglycaemia (SH) within 1 year in type 1 diabetes. We wanted to find out whether ACE activity is stable over time and predicts SH beyond 1 year, and if gender differences exist in the association between ACE activity and risk of SH.
  
  
  METHODS
  A follow-up study of 128 adult patients with type 1 diabetes was conducted. At entry, ACE activity was measured. For 12 months, patients prospectively recorded events of severe hypoglycaemia (SH). At a median of 40 months, ACE activity was measured again and participants recalled the number of SH in the last year.
  
  
  RESULTS
  ACE activity is reproducible over 40 months (p < 0.00001). Patients with SH during the baseline study also had SH during follow-up (p < 0.00001). Serum ACE activity measured at baseline was positively associated with the rate of SH at follow-up (p = 0.0003) with a 3.2-fold increased rate of SH in subjects belonging to the upper ACE quartile compared to subjects in the three lowest quartiles (p < 0.00001). The association between high serum ACE activity and increased risk of SH did not differ significantly in women and men.
  
  
  CONCLUSIONS
  In type 1 diabetes individual serum ACE activity is reproducible over time. High ACE activity predicts recurrent SH over at least 40 months with no differences between genders.
authors.affiliation: Department of Cardiology and Endocrinology H, Hillerød Hospital, Hillerød, Denmark. lof@hih.regionh.dk
authors.forename: Louise
authors.initials: L
authors.lastname: Færch
authors.forename: Ulrik
authors.initials: U
authors.lastname: Pedersen-Bjergaard
authors.forename: Birger
authors.initials: B
authors.lastname: Thorsteinsson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000201:enzymology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000201:enzymology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D007703:Peptidyl-Dipeptidase A