Genotypic abnormalities of the renin-angiotensin system have been suggested as a risk factor for the development of diabetic nephropathy and proliferative retinopathy. We studied the relationship between an insertion(I)/deletion (D) polymorphism in the angiotensin-converting enzyme (ACE) gene in insulin-dependent diabetes mellitus (IDDM) patients with diabetic nephropathy (121 men and 77 women, age 40.9 ± 10 years, diabetes duration 27 ± 8 years) and in IDDM patients with normoalbuminuria (118 men and 74 women, age 42.7 ± 10 years, diabetes duration 26 ± 8 years). A total of 155 patients (40%) had proliferative retinopathy, and 67 patients (17%) had no diabetic retinopathy. There was no difference in genotype distribution between IDDM patients with diabetic nephropathy and those with normoalbuminuria: 63 (32%)/95 (48%)/40 (20%) vs. 67 (35%)/77 (41%)/46 (24%) had DD/ID/II genotypes, respectively. Patients with nephropathy had higher plasma ACE levels (609 [151–1,504] ³g/l) compared with patients with normoalbuminuria (428 [55–1,630] ³g/l) (P < 0.001). Multiple linear regression analysis revealed that the plasma ACE level in patients with nephropathy is partially determined by ACE/ID polymorphism, mean arterial blood pressure, and glomerular filtration rate (r2 = 0.30, P < 0.001). There was no difference in genotype distribution between IDDM patients with proliferative retinopathy and those without diabetic retinopathy: 52 (34%)/74 (48%)/29 (19%) vs. 26 (39%)/25 (37%)/16 (24%) had DD/ID/II genotypes, respectively. There was also no difference in plasma ACE concentration detected among patients with no, simplex, or proliferative retinopathy. We conclude that the ACE/ID polymorphism does not contribute to the genetic susceptibility to diabetic nephropathy and proliferative retinopathy, whereas the raised plasma ACE concentration may play a role in the initiation and progression of diabetic nephropathy in Caucasian IDDM patients.
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Original Articles|
May 01 1995
Lack of Relationship Between an Insertion/Deletion Polymorphism in the Angiotensin I–Converting Enzyme Gene and Diabetic Nephropathy and Proliferative Retinopathy in IDDM Patients
Lise Tarnow;
Lise Tarnow
Steno Diabetes Center
Gentofte, Denmark
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François Cambien;
François Cambien
Institut National de la Santé et de la Recherche Médicale SC7, U367
Paris, France
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Peter Rossing;
Peter Rossing
Steno Diabetes Center
Gentofte, Denmark
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Flemming S Nielsen;
Flemming S Nielsen
Steno Diabetes Center
Gentofte, Denmark
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Birgitte V Hansen;
Birgitte V Hansen
Steno Diabetes Center
Gentofte, Denmark
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Laure Lecerf;
Laure Lecerf
Institut National de la Santé et de la Recherche Médicale SC7, U367
Paris, France
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Odette Poirier;
Odette Poirier
Institut National de la Santé et de la Recherche Médicale SC7, U367
Paris, France
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Sergei Danilov;
Sergei Danilov
Institut National de la Santé et de la Recherche Médicale SC7, U367
Paris, France
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Hans-Henrik Parving
Hans-Henrik Parving
Steno Diabetes Center
Gentofte, Denmark
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Address correspondence and reprint requests to Dr. Lise Tarnow, Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark.
Diabetes 1995;44(5):489–494
Article history
Received:
October 10 1994
Revision Received:
January 19 1995
Accepted:
January 19 1995
PubMed:
7729604
Citation
Lise Tarnow, François Cambien, Peter Rossing, Flemming S Nielsen, Birgitte V Hansen, Laure Lecerf, Odette Poirier, Sergei Danilov, Hans-Henrik Parving; Lack of Relationship Between an Insertion/Deletion Polymorphism in the Angiotensin I–Converting Enzyme Gene and Diabetic Nephropathy and Proliferative Retinopathy in IDDM Patients. Diabetes 1 May 1995; 44 (5): 489–494. https://doi.org/10.2337/diab.44.5.489
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