Angiotensin I converting enzyme gene polymorphism and diabetic nephropathy in type II diabetes.

BACKGROUND

The factors leading to diabetic nephropathy (DN) are not completely understood. Besides glycaemic control, genetic predisposition seems to play an important role for the development of DN. Genes of the renin-angiotensin system are potential candidate genes. An insertion/deletion polymorphism in the gene coding for the angiotensin I converting enzyme (ACE) has been extensively examined, but results were conflicting.

METHODS

We studied 658 patients with type II diabetes (n = 347 without DN, n = 311 with DN).

RESULTS

No difference was found in genotype distribution or allele frequencies between diabetic patients with and without nephropathy as defined by albumin excretion > or = 30 mg/day, but patients on dialysis had more frequently the DD-genotype.

CONCLUSION

Although we acknowledge certain problems in the design of the study the results in this large cohort suggest that the I/D polymorphism of the ACE gene does not play a major role in the development of DN. They are compatible, however, with a role of the gene in progression.