Grzeszczak W, Zychma M J, Lacka B, Zukowska-Szczechowska E
Department and Clinic of Internal Medicine and Diabetology, Silesian School of Medicine, Zabrze, Poland.
J Am Soc Nephrol. 1998 Sep;9(9):1664-9. doi: 10.1681/ASN.V991664.
Nephropathy is a frequent complication of long-term diabetes. Strong evidence exists that genetic predisposition plays a major role in the development of diabetic nephropathy. The role of the angiotensin I-converting enzyme gene (ACE) in the susceptibility to nephropathy in diabetes, especially in non-insulin dependent diabetes mellitus (NIDDM), remains unclear. This study examines the association of two ACE polymorphisms: a 287-bp insertion/deletion (I/D) in intron 16 and PstI (A/G substitution in intron 7; alleles P/M) with renal complications in 941 NIDDM patients. From this group, for further analysis 127 patients were selected with overt proteinuria or chronic renal failure, 335 patients with microalbuminuria, and a control group of 254 normoalbuminuric patients with a diabetes duration of at least 10 yr. No significant differences in the distribution of ACE I/D and PstI genotypes or allele frequencies were observed between the examined groups. The results of this study strongly suggest that there is no association between the ACE gene I/D and PstI polymorphisms and nephropathy in NIDDM.
肾病是长期糖尿病常见的并发症。有确凿证据表明，遗传易感性在糖尿病肾病的发生发展中起主要作用。血管紧张素I转换酶基因（ACE）在糖尿病肾病易感性中的作用，尤其是在非胰岛素依赖型糖尿病（NIDDM）中的作用仍不清楚。本研究检测了941例NIDDM患者中ACE基因的两种多态性：第16内含子287bp插入/缺失（I/D）和PstI（第7内含子A/G替换；等位基因P/M）与肾脏并发症的关系。从该组中，进一步分析选取了127例有显性蛋白尿或慢性肾衰竭的患者、335例微量白蛋白尿患者以及254例糖尿病病程至少10年的正常白蛋白尿患者作为对照组。在各检测组之间，未观察到ACE I/D和PstI基因型分布或等位基因频率有显著差异。本研究结果强烈提示，NIDDM患者中ACE基因I/D和PstI多态性与肾病之间无关联。
