title: Relationship among angiotensin-converting enzyme polymorphism, cardiovascular risk, and osteoporotic fractures.
abstract: OBJECTIVE
  Angiotensin-converting enzyme (ACE) has been related to cardiovascular physiology and bone remodeling. Our aim was to assess the relationship among ACE polymorphisms, cardiovascular risk, and osteoporotic fractures.
  
  
  METHODS
  We prospectively enrolled 71 patients with hypertension from 2001 to 2014. Sociodemographic and medical data were collected. Comorbidity was evaluated with Charlson index. Densitometric studies on lumbar spine were performed. ACE polymorphism was analyzed by polymerase chain reaction. Data were analyzed using SPSS 15.0 (p value <0.05).
  
  
  RESULTS
  Homozygous deletion (DD) genotype was described in 32.4% of patients, homozygous insertion (II) in 19.7%, and heterozygous insertion/deletion (ID) in 47.9%. On stratifying data by ACE polymorphism, we observed that DD carriers demonstrated neither greater cardiovascular risk factors (30.4% vs. 33.3%, p=0.4) and higher comorbidity (34.8% vs. 22.9%, p=0.3) nor higher osteoporotic fracture incidence (17.4% vs. 16.8%, p=0.9). In women, no significant differences were observed between DD homozygous individuals and ID+II subjects.
  
  
  CONCLUSIONS
  It is unclear whether DD genotype is an independent risk factor for cardiovascular disease. In contrast to our expectations, we found no relationship among the DD genotype, cardiovascular risk, and osteoporotic fracture incidence.
authors.affiliation: Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain.
authors.forename: Laisa Socorro
authors.initials: LS
authors.lastname: Briongos-Figuero
authors.affiliation: Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: Cuadrado-Medina
authors.affiliation: Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Abad-Manteca
authors.affiliation: Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Vega-Tejedor
authors.affiliation: Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Pineda-Alonso
authors.affiliation: Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Pérez-Castrillón
keywords: Angiotensin-converting enzyme polymorphism/genetic; cardiovascular diseases; fractures bone; hypertension; osteoporosis