Jhawat Vikas, Gupta Sumeet, Agarwal Bimal K, Roy Partha, Saini Vipin
Department of Pharmaceutical Sciences, G. D. Goenka, Gurugram, Haryana, India.
Department of Pharmacology, M. M. College of Pharmacy, M. M. (Deemed to be University), Mullana (Ambala), Haryana, India.
Clin Med Insights Endocrinol Diabetes. 2019 Jan 23;12:1179551418825037. doi: 10.1177/1179551418825037. eCollection 2019.
Antihypertensive drug therapies have been reported to be associated with new onset of type 2 diabetes mellitus in some hypertensive patients after prolonged use. Angiotensin converting enzyme (ACE) gene has been found to affect essential hypertension, response of antihypertensive therapies, and glycemic disturbances. Therefore, ACE gene I/D polymorphism may be associated with risk of new onset of type 2 diabetes via metabolic disturbances, glycemic dysregulation, and insulin resistance.
To assess the correlation between ACE gene I/D polymorphism and glycemic disturbance under influence of diuretic and other antihypertensive drug therapies.
We recruited 270 normotensive patients as control (150 men and 120 women), 270 hypertensive patients (95 men and 175 women), and 240 hypertensive with new onset of diabetes patients (80 men and 160 women). All samples were genotyped for ACE gene polymorphic alleles and relationship between different genotypes and anthropometric and clinical parameters along with drug therapies was established and analyzed.
Baseline clinical (systolic blood pressure, diastolic blood pressure, and fasting blood glucose level) and anthropometric parameters (height, weight, waist circumference, hip circumference, waist-hip ratio, and body mass index) of study populations were found highly statistically significant ( < .05) when compared among study groups. Furthermore, genotype wise comparison of all these parameters in essential hypertensive (EH) and essential hypertensive with onset of diabetes (EHNOD) patients found most of them nonsignificant and no variation was found with respect to different genotypes of ACE gene. The genotype wise comparison of clinical parameters among different antihypertensive drug therapy was found statistically nonsignificant in both EH and EHNOD patients.
Anthropometric parameters can be taken as the risk indicator factors for hypertension and diabetes. However, ACE gene polymorphism may not be a risk factor for development of diabetes in hypertensive patients.
The present study suggested that ACE gene polymorphism did not show any significant association with the risk of new onset of diabetes in EH patients and more detailed studies with large population size are needed.
据报道，在一些高血压患者长期使用降压药物治疗后，会出现2型糖尿病新发情况。已发现血管紧张素转换酶（ACE）基因会影响原发性高血压、降压治疗反应以及血糖紊乱。因此，ACE基因I/D多态性可能通过代谢紊乱、血糖失调和胰岛素抵抗与2型糖尿病新发风险相关。
评估在利尿剂和其他降压药物治疗影响下，ACE基因I/D多态性与血糖紊乱之间的相关性。
我们招募了270名血压正常的患者作为对照组（150名男性和120名女性）、270名高血压患者（95名男性和175名女性）以及240名高血压合并新发糖尿病患者（80名男性和160名女性）。对所有样本进行ACE基因多态性等位基因基因分型，并确定不同基因型与人体测量和临床参数以及药物治疗之间的关系并进行分析。
研究人群的基线临床参数（收缩压、舒张压和空腹血糖水平）和人体测量参数（身高、体重、腰围、臀围、腰臀比和体重指数）在各研究组之间进行比较时，发现具有高度统计学意义（P<0.05）。此外，在原发性高血压（EH）患者和原发性高血压合并糖尿病发病（EHNOD）患者中，对所有这些参数进行基因型比较时，发现大多数无统计学意义，并且未发现ACE基因不同基因型之间存在差异。在EH和EHNOD患者中，不同降压药物治疗之间临床参数的基因型比较在统计学上无显著意义。
人体测量参数可作为高血压和糖尿病的风险指标因素。然而，ACE基因多态性可能不是高血压患者发生糖尿病的风险因素。
本研究表明，ACE基因多态性与EH患者新发糖尿病风险无显著关联，需要进行更大规模人群的更详细研究。
