Celik Umit Sizmaz, Noyan Aytül, Bayazit Aysun K, Büyükçelik Mithat, Dursun Hasan, Anarat Ali, Attila Gülen, Matyar Selçuk
Department of Pediatric Nephrology, Cukurova University, School of Medicine, Adana, Turkey.
Ren Fail. 2006;28(5):401-3. doi: 10.1080/08860220600599084.
Since 1990, the role of angiotensin converting enzyme (ACE) gene polymorphism in various renal and cardiac diseases is still debated. This study comprised 71 pediatric patients with nephrotic syndrome, 47 males (66%) and 24 females (34%) with a mean age of 57.4 +/- 37.6 months, and a control group of 83 healthy males (59%) and 57 healthy females (41%) with a mean age of 505 +/- 160.5 months. The distribution of the ACE genotype in the control group was II, 11%; ID, 53%; and DD, 36%, and the nephrotic syndrome was II, 4%; ID, 78%; and DD, 18%. Angiotensin-converting enzyme genotypes were significantly different between patients and control groups (p<0.05). The study groups consisted of 52 (73%) with steroid-sensitive nephrotic syndrome (SNSS) and 19 (27%) with steroid-resistant nephrotic syndrome (SRNS). The distribution of the ACE genotype was II, 6%; ID, 75%; and DD, 19% in the SSNS population and ID, 84% and DD, 16% in the SRNS population. No statistically significant difference was found between steroid sensitivity and ACE genotypes (p=0.5). The results show that ACE I/D polymorphism does not contribute to the steroid resistance, even though this study indicates that the presence of the I/D genotype has a much higher risk--approximately 2.8 times--of having nephrotic syndrome. Further studies with a larger number of patients are needed.
自1990年以来，血管紧张素转换酶（ACE）基因多态性在各种肾脏和心脏疾病中的作用仍存在争议。本研究纳入了71例肾病综合征患儿，其中47例男性（66%），24例女性（34%），平均年龄为57.4±37.6个月，以及一个对照组，包括83例健康男性（59%）和57例健康女性（41%），平均年龄为505±160.5个月。对照组中ACE基因型的分布为：II型，11%；ID型，53%；DD型，36%，而肾病综合征组为：II型，4%；ID型，78%；DD型，18%。患者组和对照组之间的血管紧张素转换酶基因型存在显著差异（p<0.05）。研究组包括52例（73%）激素敏感型肾病综合征（SNSS）患者和19例（27%）激素抵抗型肾病综合征（SRNS）患者。在SNSS人群中，ACE基因型的分布为：II型，6%；ID型，75%；DD型，19%，在SRNS人群中为：ID型，84%，DD型，16%。激素敏感性和ACE基因型之间未发现统计学显著差异（p=0.5）。结果表明，ACE I/D多态性与激素抵抗无关，尽管本研究表明I/D基因型的存在患肾病综合征的风险要高得多，约为2.8倍。需要对更多患者进行进一步研究。
