Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Madhya Marg, Chandigarh, 160012, India.
Department of Biochemistry, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, 249201, India.
Biochem Genet. 2021 Feb;59(1):335-345. doi: 10.1007/s10528-020-10011-0. Epub 2020 Nov 2.
Uncontrolled diabetes mellitus may affect any part of the gastrointestinal tract (GIT) and impact negatively the quality of life. Angiotensin-converting enzyme (ACE) gene polymorphism can have direct effect on circulating level of ACE which further modifies the degradation of substance P and thus may influence the gut motility. Hence, it could be hypothesised that ACE gene polymorphism would influence the gut motility. An observational analytical study was conducted at PGIMER, Chandigarh. 300 Type2 diabetes mellitus (T2DM) and 200 age and sex matched healthy individuals were enrolled. After taking written consent, 5 ml blood sample was collected for measurement of substance P by ELISA method and for ACE gene polymorphism (insertion[I]/deletion[D]) by polymerase chain reaction. Orocecal transit time (OCTT) was measured using non-invasive lactulose breath test. Out of 300 diabetic patients, 32.7%, 44% and 23.3% belonged to II, ID and DD genotypes, respectively. The frequency of D allele (OR = 1.39) and DD genotype (OR = 2.17) was significantly higher in patients than in controls and was associated with increased risk. Moreover, more number of diabetes patients with constipation (90%) belonged to DD genotype and their OCTT was significantly delayed (166.7 ± 7.3 min) as compared to ID (143.5 ± 4.2 min) or II (121.8 ± 4.9 min) genotype. From this study, it could be concluded that ACE gene polymorphism could be an important contributing factor to influence the gut motility and thus giving rise to the GI symptoms for T2DM patients.
未控制的糖尿病可能会影响胃肠道 (GIT) 的任何部位，并对生活质量产生负面影响。血管紧张素转换酶 (ACE) 基因多态性可直接影响 ACE 的循环水平，从而进一步改变 P 物质的降解，从而可能影响肠道动力。因此，可以假设 ACE 基因多态性会影响肠道动力。在昌迪加尔的 PGIMER 进行了一项观察性分析研究。纳入了 300 名 2 型糖尿病 (T2DM) 患者和 200 名年龄和性别匹配的健康对照者。在获得书面同意后，采集 5ml 血样，通过 ELISA 法测量 P 物质，通过聚合酶链反应测量 ACE 基因多态性（插入 [I]/缺失 [D]）。使用非侵入性乳果糖呼气试验测量口盲传输时间 (OCTT)。在 300 名糖尿病患者中，II、ID 和 DD 基因型分别占 32.7%、44%和 23.3%。与对照组相比，患者中 D 等位基因（OR=1.39）和 DD 基因型（OR=2.17）的频率显著更高，与风险增加相关。此外，更多患有便秘的糖尿病患者（90%）属于 DD 基因型，其 OCTT 明显延迟（166.7±7.3 分钟），而 ID（143.5±4.2 分钟）或 II（121.8±4.9 分钟）基因型。从这项研究中可以得出结论，ACE 基因多态性可能是影响肠道动力的重要因素，从而导致 T2DM 患者出现胃肠道症状。
