Pfohl M, Frost D, Koch M, Clemens P, Patzies A, Schmülling R M, Beischer W, Häring H U
Department of Medicine, University of Tübingen, Germany.
Horm Metab Res. 1998 May;30(5):276-80. doi: 10.1055/s-2007-978883.
The insertion/deletion (I/D) polymorphism of the angiotensin-converting-enzyme (ACE) gene has been reported to be associated with diabetic nephropathy in IDDM. We studied the relationship between this polymorphism and diabetic nephropathy in 210 IDDM patients. Their DNA was analyzed by polymerase chain reaction to type for the presence (I) or absence (D) of the 287 bp fragment in intron 16 of the ACE gene. The relative frequency of the different genotypes was 33.8% (DD), 43.8% (ID), and 22.4% (II). There were no significant differences between the genotypes in age, body-mass-index, blood pressure, plasma total cholesterol and triglycerides. The prevalence of microalbuminuria or nephropathy was 23.9% in the DD, 16.3% in the ID, and 17% in the II genotypes. The higher percentage of microalbuminuria or nephropathy in the DD genotypes was due to an increasing frequency of DD genotypes in the IDDM patients with long diabetes duration. After matching for diabetic retinopathy, gender, and diabetes duration, there was no association between the ACEI/D polymorphism and diabetic nephropathy. In conclusion, these results suggest that the ACE DD genotype cannot be regarded as a risk factor for diabetic nephropathy, but may even be associated with diabetes duration and thus longevity in IDDM patients.
血管紧张素转换酶(ACE)基因的插入/缺失(I/D)多态性已被报道与胰岛素依赖型糖尿病(IDDM)中的糖尿病肾病相关。我们研究了210例IDDM患者中这种多态性与糖尿病肾病之间的关系。通过聚合酶链反应分析他们的DNA,以确定ACE基因第16内含子中287 bp片段的存在(I)或缺失(D)类型。不同基因型的相对频率分别为33.8%(DD)、43.8%(ID)和22.4%(II)。各基因型在年龄、体重指数、血压、血浆总胆固醇和甘油三酯方面无显著差异。DD基因型中微量白蛋白尿或肾病的患病率为23.9%,ID基因型为16.3%,II基因型为17%。DD基因型中微量白蛋白尿或肾病的比例较高是由于糖尿病病程较长的IDDM患者中DD基因型的频率增加。在匹配糖尿病视网膜病变、性别和糖尿病病程后,ACE I/D多态性与糖尿病肾病之间无关联。总之,这些结果表明,ACE DD基因型不能被视为糖尿病肾病的危险因素,甚至可能与糖尿病病程以及IDDM患者的寿命相关。