Gutiérrez C, Vendrell J, Pastor R, Llor C, Aguilar C, Broch M, Richart C
Internal Medicine Department, Hospital Universitari Joan XXIII, Tarragona, Spain.
Metabolism. 1997 Aug;46(8):976-80. doi: 10.1016/s0026-0495(97)90090-1.
Genotypic abnormalities of the renin-angiotensin system have been suggested as a risk factor for the development of microangiopathic complications in diabetic patients. We studied the relationship of either an insertion-deletion polymorphism in the angiotensin-converting enzyme (ACE) gene and the M235T and T174M variant polymorphisms of the angiotensinogen (AGT) gene in non-insulin-dependent diabetes mellitus (NIDDM) patients and its relationship with cardiovascular complications. A total of 193 NIDDM patients (89 men and 104 women aged 59.2 +/- 10.0 years; diabetes duration, 13.2 +/- 6.2 years) and 90 control subjects (42 men and 48 women aged 45.4 +/- 12.6 years) were recruited for the association study. Distribution of the genotype or allelic frequencies for all the studied polymorphisms did not differ significantly between controls and NIDDM patients. ACE and AGT genes did not display any difference in clinical or metabolic parameters according to each gene's genotype for either the control or the NIDDM group. For evaluation of nephropathy and retinopathy, NIDDM patients were matched with subjects not having microangiopathic complications. Thus, a total of 60 patients had diabetic nephropathy and were compared with 100 patients with normoalbuminuria. Sixty-eight NIDDM patients had diabetic retinopathy, and 92 patients presented no signs of retinopathy. There were no differences in genotypic or allelic distribution between NIDDM patients for either the presence or absence of retinopathy or nephropathy. We conclude that the ACE and AGT polymorphisms do not contribute to the genetic susceptibility to diabetic nephropathy and retinopathy in a caucasian Mediterranean population.
肾素 - 血管紧张素系统的基因异常被认为是糖尿病患者微血管并发症发生的一个危险因素。我们研究了血管紧张素转换酶（ACE）基因的插入 - 缺失多态性以及血管紧张素原（AGT）基因的M235T和T174M变异多态性与非胰岛素依赖型糖尿病（NIDDM）患者的关系及其与心血管并发症的关系。共招募了193例NIDDM患者（89例男性和104例女性，年龄59.2±10.0岁；糖尿病病程13.2±6.2年）和90例对照者（42例男性和48例女性，年龄45.4±12.6岁）进行关联研究。在对照者和NIDDM患者之间，所有研究多态性的基因型或等位基因频率分布没有显著差异。对于对照组和NIDDM组，根据每个基因的基因型，ACE和AGT基因在临床或代谢参数上均未显示出任何差异。为了评估肾病和视网膜病变，将NIDDM患者与没有微血管并发症的受试者进行匹配。因此，共有60例患者患有糖尿病肾病，并与100例正常白蛋白尿患者进行比较。68例NIDDM患者患有糖尿病视网膜病变，92例患者没有视网膜病变迹象。无论是否存在视网膜病变或肾病，NIDDM患者之间的基因型或等位基因分布均无差异。我们得出结论，在高加索地中海人群中，ACE和AGT多态性对糖尿病肾病和视网膜病变的遗传易感性没有影响。
