Hosoi M, Nishizawa Y, Kogawa K, Kawagishi T, Konishi T, Maekawa K, Emoto M, Fukumoto S, Shioi A, Shoji T, Inaba M, Okuno Y, Morii H
Second Department of Internal Medicine, Osaka City, University Medical School, Japan.
Circulation. 1996 Aug 15;94(4):704-7. doi: 10.1161/01.cir.94.4.704.
The insertion/deletion (I/D) polymorphism of the ACE gene has been shown to be associated with cardiovascular disease in healthy subjects as well as in patients with non-insulin-dependent diabetes mellitus (NIDDM). We investigated the relationship between the ACE gene polymorphism and the wall thickness of both carotid and femoral arteries in NIDDM patients.
We measured the intimal plus medial thickness (IMT) of both carotid and femoral arteries using high-resolution B-mode ultrasonography in 288 Japanese NIDDM patients (160 men, 128 women). No significant differences among the three genotypes were found with respect to age, sex, duration of diabetes, body mass index, blood pressure, plasma glucose, hemoglobin AIC, total cholesterol, triglycerides, HDL cholesterol, or cigarette-years. Plasma ACE levels were strongly associated with I/D polymorphism, with an additive effect of the D alleles. The carotid IMT of the patients carrying the D allele (DD+ID genotype) was significantly higher than that of the patients not carrying the D allele (II genotype) (P = .037), whereas the femoral IMT was not affected by the I/D polymorphism. Multiple regression analysis demonstrated that the risk factors for carotid IMT of patients with NIDDM were age, non-HDL cholesterol, and D allele of the ACE gene (R2 = .155, P < .0001).
The D allele of the ACE gene may be a risk factor for the development of wall thickening of the carotid but not the femoral artery in NIDDM patients.
血管紧张素转换酶（ACE）基因的插入/缺失（I/D）多态性已被证明与健康受试者以及非胰岛素依赖型糖尿病（NIDDM）患者的心血管疾病有关。我们研究了NIDDM患者中ACE基因多态性与颈动脉和股动脉壁厚度之间的关系。
我们使用高分辨率B型超声测量了288例日本NIDDM患者（160例男性，128例女性）的颈动脉和股动脉内膜加中膜厚度（IMT）。在年龄、性别、糖尿病病程、体重指数、血压、血糖、糖化血红蛋白A1C、总胆固醇、甘油三酯、高密度脂蛋白胆固醇或吸烟年限方面，三种基因型之间未发现显著差异。血浆ACE水平与I/D多态性密切相关，D等位基因具有累加效应。携带D等位基因（DD + ID基因型）的患者颈动脉IMT显著高于未携带D等位基因（II基因型）的患者（P = .037），而股动脉IMT不受I/D多态性影响。多元回归分析表明，NIDDM患者颈动脉IMT的危险因素是年龄、非高密度脂蛋白胆固醇和ACE基因的D等位基因（R2 = .155，P < .0001）。
ACE基因的D等位基因可能是NIDDM患者颈动脉壁增厚而非股动脉壁增厚的危险因素。
