Tkác Ivan, Salagovic Ján, Kozárová Miriam, Rosolová Hana, Molcányiová Angela, Mosorjáková Dana, Chleborádová Martina, Kalina Ivan
Department of Medicine IV, Faculty of Medicine, Safárik University, Kosice, Slovakia.
Wien Klin Wochenschr. 2003 Jan 31;115(1-2):36-40. doi: 10.1007/BF03040270.
To evaluate the influence of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on lipid levels in patients with Type 2 diabetes.
109 patients with Type 2 diabetes were included. The patients were not on any lipid-lowering treatment. The groups with different ACE genotypes had similar ages, sex distributions, body mass indices, systolic blood pressures and indices of glycaemic control. ACE gene I/D polymorphism was determined using polymerase chain reaction.
The mean apolipoprotein B (apoB) level was significantly higher in the group of DD homozygotes compared with the subjects with at least one insertion allele (DD: 1.21 +/- 0.25 g/l vs. ID + II: 1.04 +/- 0.27 g/l; P = 0.007). Significant correlations between glycated haemoglobin (HbA1c) and both apoB and cholesterol levels were found (r = 0.27; P < 0.01). For the apoB, this correlation was highly significant in the DD-genotype subgroup (r = 0.54; P < 0.01), and was not significant in the subgroup of patients with genotypes ID or II. In the multivariate analysis, HbA1c and the interaction of genotype DD with HbA1c were significant independent predictors of apoB (r2 = 0.17) and cholesterol levels.
The present study showed that the interaction between the DD genotype of angiotensin-converting enzyme and chronic hyperglycaemia (expressed by HbA1c level) is related to higher plasma levels of atherogenic lipoproteins, such as apoB and cholesterol, in patients with Type 2 diabetes.
评估血管紧张素转换酶（ACE）插入/缺失（I/D）多态性对2型糖尿病患者血脂水平的影响。
纳入109例2型糖尿病患者。这些患者未接受任何降脂治疗。不同ACE基因型组在年龄、性别分布、体重指数、收缩压和血糖控制指标方面相似。采用聚合酶链反应确定ACE基因的I/D多态性。
与至少有一个插入等位基因的受试者相比，DD纯合子组的平均载脂蛋白B（apoB）水平显著更高（DD：1.21±0.25 g/l，ID+II：1.04±0.27 g/l；P=0.007）。发现糖化血红蛋白（HbA1c）与apoB和胆固醇水平之间存在显著相关性（r=0.27；P<0.01）。对于apoB，这种相关性在DD基因型亚组中高度显著（r=0.54；P<0.01），而在ID或II基因型患者亚组中不显著。在多变量分析中，HbA1c以及基因型DD与HbA1c的相互作用是apoB（r2=0.17）和胆固醇水平的显著独立预测因素。
本研究表明，血管紧张素转换酶的DD基因型与慢性高血糖（由HbA1c水平表示）之间的相互作用与2型糖尿病患者血浆中致动脉粥样硬化脂蛋白（如apoB和胆固醇）的较高水平有关。
