title: Angiotensin-converting enzyme gene insertion/deletion polymorphism in nutritional disorders in children.
abstract: OBJECTIVE
  The aim of this study was to establish the role of angiotensin-converting enzyme gene insertion/deletion (ACE I/D) polymorphism in determining obesity or undernutrition in a child population in Romania.
  
  
  METHODS
  We assessed 293 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided, according to body mass index (BMI), into three groups: group I, the control group consisting of 126 children, group II patients with undernutrition (85 patients) and group III patients with obesity (82 patients). ACE I/D polymorphisms were performed in all three patient groups, as well as the measuring of anthropometric parameters [middle upper arm circumference (MUAC), tricipital skinfold thickness (TST)]. All patients also underwent paraclinical evaluations (protein and albumin). The cutoffs criteria for moderate undernutrition were: BMI between -2.0 SD and -3.0 SD, severe undernutrition: BMI <-3.0 SD, moderate obesity: BMI between +2.0 SD and +3.0 SD and severe obesity: BMI >+3.0 SD.
  
  
  RESULTS
  We observed that DD genotype (64.7%) was prevalent in the moderate undernutrition group, while ID (35.3%) and II genotypes were higher in the subgroup of severe undernutrition, with significant correlations in DD and ID genotype groups between BMI and MUAC, protein and albumin (p < 0.0001). In the obese group, we observed significant correlations in DD genotype, between BMI and MUAC (p = 0.0014) and TST, and for II genotype, between BMI and TST (p = 0.0071). II genotype was associated with severe obesity, while D allele carriers were associated with moderate undernutrition and moderate obesity.
  
  
  CONCLUSIONS
  BMI, MUAC, TST and serum protein levels are correlated with D allele carriers of ACE genes in children with moderate undernutrition and moderate obesity, whereas II genotype is an unfavorable prognostic factor corresponding to severe obesity and severe undernutrition.
authors.affiliation: Pediatrics Clinic I, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania.
authors.forename: Cristina Oana
authors.initials: CO
authors.lastname: Mărginean
authors.affiliation: Departement of Medical Genetics, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania. claudia.banescu@umftgm.ro.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bănescu
authors.affiliation: Pediatrics Clinic I, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania.
authors.forename: Carmen
authors.initials: C
authors.lastname: Duicu
authors.affiliation: Departement of Epidemiology, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania.
authors.forename: Septimiu
authors.initials: S
authors.lastname: Voidăzan
authors.affiliation: Departement of Obstetrics and Gynecology, University of Medicine and Pharmacy Tîrgu Mureş, Tîrgu Mureş, Romania.
authors.forename: Claudiu
authors.initials: C
authors.lastname: Mărginean
mesh_terms: D000293:Adolescent; D000483:Alleles; D015992:Body Mass Index; D002648:Child; D015362:Child Nutrition Disorders / Q000175:diagnosis* / Q000235:genetics*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D017353:Gene Deletion; D060005:Genotyping Techniques; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000235:genetics; D016254:Mutagenesis, Insertional; D009765:Obesity / Q000175:diagnosis / Q000235:genetics; D007703:Peptidyl-Dipeptidase A / Q000235:genetics* / Q000378:metabolism; D011110:Polymorphism, Genetic; D011379:Prognosis; D012383:Romania
chemical_list: D007703:Peptidyl-Dipeptidase A
keywords: ACE I/D polymorphism; Children; Obesity; Undernutrition