title: The association of ACE gene polymorphism with diabetic kidney disease and renoprotective efficacy of valsartan.
abstract: BACKGROUND
  To investigate the associations between the insertion/deletion (I/D) polymorphisms in the angiotensin converting enzyme (ACE) gene and susceptibility to diabetic kidney disease (DKD); and the efficacy of valsartan in reducing the urine protein in Type 2 diabetes mellitus (T2DM) patients.
  
  
  METHODS
  We enrolled 128 T2DM patients in this study, including 54 cases with DKD (DKD+) and 74 controls (DKD-). The ACE polymorphism was assayed by polymerase chain reaction (PCR), and the genotype distribution and allele frequency were analyzed. The DKD+ group was subdivided into the DD, ID and II subgroups, based on their genotypes. In addition, patients with DKD received valsartan treatment for 12 weeks. We determined changes in the urinary albumin to creatinine ratio (ACR) and serum creatinine (SCr).
  
  
  RESULTS
  The frequencies of the genotypes DD and ID were higher in the DKD+ than in the DKD- group. The frequency of allele D was higher, and of allele I was lower, in the DKD+ than in DKD- group (p < 0.05). Following valsartan treatment, albuminuria was significantly decreased in subgroups DD and ID (p < 0.05).
  
  
  CONCLUSIONS
  In T2DM patients, the ACE I/D polymorphism was associated with onset of DKD. Furthermore, the ACE I/D polymorphism influenced the renoprotective response to valsartan: Patients with the DD genotype benefitted the most from this treatment.
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
authors.forename: Yuying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Peng
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
authors.forename: Xiaoxue
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
authors.forename: Huibo
authors.initials: H
authors.lastname: Qiao
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Endocrinology, Affiliated People's Hospital, Jiangsu University, Zhenjiang, China Wcgzj1128@aliyun.com.
authors.forename: Chenguang
authors.initials: C
authors.lastname: Wu
mesh_terms: D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics*; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D020011:Protective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000068756:Valsartan / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D020011:Protective Agents; D000068756:Valsartan; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A
keywords: Angiotensin converting enzyme; diabetes; diabetes mellitus Type 2; diabetic kidney disease; end stage renal disease; gene polymorphisms; kidney disease; microangiopathy; microvascular complications; valsartan