Ukkola O, Savolainen M J, Salmela P I, von Dickhoff K, Kiema T, Kesäniemi Y A
Department of Internal Medicine and Biocenter Oulu, University of Oulu, Finland.
J Mol Med (Berl). 1995 Jun;73(6):307-11. doi: 10.1007/BF00231617.
In the search for new risk factors for diabetic macroangiopathy the insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme gene was studied in 237 consecutive patients (125 men and 112 women) with non-insulin-dependent diabetes. The female population showed an excess of ischemic electrocardiographic changes or definite myocardial infarctions in the patients homozygous for the deletion [D/D; odds ratio (OR) 2.8; 95% confidence interval (CI) 1.4-5.3] and in the insertion/deletion heterozygotes (I/D; OR 1.8; CI 1.1-3.1) compared with the patients homozygous for the insertion (I/I). In the total series coronary heart disease, cerebrovascular disease, and claudication were more often observed in the patients with I/D (OR 1.5; CI 1.0-2.2) or the D/D genotype patients (OR 1.7; CI 1.1-2.6) than in those with the genotype I/I. The systolic blood pressure was lower in patients with genotype I/I (138 +/- 19 mmHg) than in those with the genotype I/D (149 +/- 22 mmHg) or D/D (150 +/- 21 mmHg; P < 0.02). The prevalence of hypertension and the median urinary albumin excretion rate also tended to be lowest in the I/I genotype patients. Multiple logistic analysis revealed that in women the angiotensin-converting enzyme D/D genotype is independently associated with coronary heart disease. Our findings suggest that variation at the angiotensin-converting enzyme gene locus is one of the factors involved in the predisposition of diabetic patients to the development of arterial disease and hypertension.
在寻找糖尿病大血管病变新的危险因素时，对237例非胰岛素依赖型糖尿病连续患者（125例男性和112例女性）进行了血管紧张素转换酶基因插入/缺失（I/D）多态性研究。与插入纯合子（I/I）患者相比，女性群体中缺失纯合子（D/D）患者[优势比（OR）2.8；95%置信区间（CI）1.4 - 5.3]和插入/缺失杂合子（I/D）患者（OR 1.8；CI 1.1 - 3.1）出现缺血性心电图改变或明确心肌梗死的比例更高。在整个系列中，与I/I基因型患者相比，I/D基因型患者（OR 1.5；CI 1.0 - 2.2）或D/D基因型患者（OR 1.7；CI 1.1 - 2.6）更常出现冠心病、脑血管疾病和间歇性跛行。I/I基因型患者的收缩压（138±19 mmHg）低于I/D基因型患者（149±22 mmHg）或D/D基因型患者（150±21 mmHg；P<0.02）。I/I基因型患者的高血压患病率和尿白蛋白排泄率中位数也往往最低。多因素逻辑分析显示，在女性中，血管紧张素转换酶D/D基因型与冠心病独立相关。我们的研究结果表明，血管紧张素转换酶基因位点的变异是糖尿病患者易患动脉疾病和高血压的因素之一。
