title: Angiotensin-converting enzyme genotype and peripheral arterial disease in diabetic patients.
abstract: We investigated the effect of traditional risk factors (hypertension, dyslipidemia and smoking) on the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and peripheral arterial disease (PAD) in 945 (454 men and 491 women) Taiwanese type 2 diabetic patients with a mean age of 63.5 (SD: 11.4) years. Among them, 81 (31 men and 50 women) had PAD (ankle-brachial index <0.9). The adjusted odds ratios (95% confidence intervals) were 2.48 (1.18-5.21), 1.69 (1.00-2.85) and 1.64 (1.12-2.39), respectively, for recessive (DD versus II + ID), dominant (DD + ID versus II) and additive (II = 0, ID = 1 and DD = 2) models. While analyzing the interaction between DD and the individual risk factor of hypertension, smoking and dyslipidemia, patients with the risk factor and with DD had the highest risk compared to referent patients without the risk factor and with II/ID. The respective adjusted odds ratios were 5.41 (2.05-14.31), 7.38 (1.87-29.06) and 4.64 (1.70-12.64). We did not find a significant interaction between DD and any of the risk factors under multiplicative or additive scale. In conclusion, traditional risk factors (hypertension, smoking and dyslipidemia) play an important role in the association between ACE genotypes and PAD. Patients with DD genotype and traditional risk factors are at the highest risk.
authors.affiliation: Department of Internal Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan. ccktsh@ms6.hinet.net
authors.forename: Chin-Hsiao
authors.initials: CH
authors.lastname: Tseng
authors.forename: Farn-Hsuan
authors.initials: FH
authors.lastname: Tseng
authors.forename: Choon-Khim
authors.initials: CK
authors.lastname: Chong
authors.forename: Ching-Ping
authors.initials: CP
authors.lastname: Tseng
authors.forename: Ju-Chien
authors.initials: JC
authors.lastname: Cheng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000235:genetics; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000208:ethnology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D054643:INDEL Mutation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000502:physiology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A