Lee D Y, Kim W, Kang S K, Koh G Y, Park S K
Department of Pediatrics, Institute for Medical Science, Chonbuk National University Medical School, Chonju, Korea.
Nephron. 1997;77(4):471-3. doi: 10.1159/000190326.
To evaluate angiotensin-converting enzyme (ACE) gene insertion/deletion polymorphism in nephrotic syndrome, 85 patients (minimal-change nephrotic syndrome, MCNS: 55 cases; focal segmental glomerulosclerosis, FSGS: 30 cases) and 61 control subjects were examined. The distribution of ACE genotype in the control group was II 44%, ID 41% and DD 15%. The distribution of ACE genotypes in MCNS was similar to that in controls. However, the distribution of ACE genotypes in FSGS was markedly different from those of MCNS. The DD genotype was more frequent (p < 0.05) in FSGS than in MCNS. Patients with the DD genotype tended to present clinical symptoms at an earlier age. They also showed a lower responsiveness to corticosteroid therapy and a higher incidence of chronic renal failure than those with other genotypes. Our results indicate that the ACE DD genotype in FSGS may be a risk factor for the poor responsiveness to steroid therapy and the development of chronic renal failure.
为评估血管紧张素转换酶（ACE）基因插入/缺失多态性与肾病综合征的关系，我们检测了85例患者（微小病变型肾病综合征，MCNS：55例；局灶节段性肾小球硬化症，FSGS：30例）及61例对照者。对照组中ACE基因型的分布为：II型44%，ID型41%，DD型15%。MCNS组中ACE基因型的分布与对照组相似。然而，FSGS组中ACE基因型的分布与MCNS组明显不同。FSGS组中DD基因型的频率高于MCNS组（p < 0.05）。携带DD基因型的患者往往在较早年龄出现临床症状。与其他基因型患者相比，他们对糖皮质激素治疗的反应性较低，慢性肾衰竭的发生率较高。我们的结果表明，FSGS中的ACE DD基因型可能是类固醇治疗反应不佳及慢性肾衰竭发生的危险因素。
