ACE Gene Polymorphism and the Development of Microalbuminura in Korean Type 2 Diabetes Patients / 대한신장학회지

ABSTRACT

PURPOSE: Pathophysiological causes of the development and progression of diabetic nephropathy are not well known, but the angiotensin-converting enzyme (ACE) gene polymorphism has been proposed to be involved in its development. To clarify risk factors for the development of microalbuminuria in Korean type 2 diabetes patients, a retrospective study on the last 10 years was conducted on outpatients with type 2 diabetes. METHODS: The impact of insertion/deletion (I/D) genotypes on the progression of diabetic nephropathy in 105 Korean type 2 diabetes patients with normoalbuminuria at diagnosis was investigated by retrospective review of clinical data. Polymorphisms of the ACE gene were examined. RESULTS: During the follow up over the last 10 years, 23 of 105 patients developed Microalbuminuria (21.9%). ACE genotypes were D/D 19.5%, D/I 41.5%, I/I 39% in microalbuminuria group, as compared with D/D 17.4%, I/D 26.1%, I/I 56.5% in normoalbuminuria group. Higher levels of mean HbA1c and mean triglyceride were noted in microalbuminuira group, as compared with those in normoalbuminuria group. Kaplan-Meier survival curve showed that higher HbA1c and higher triglyceride level were significant predictors to the development of Microalbuminuria, but I/D genotype of ACE gene did not affect. Cox regression model also showed that higher HbA1c and triglyceride were independent variables. CONCLUSION: The control of blood glucose or lipid, rather than the genetic factors such as ACE polymorphism, was considered to be more influential factor on the development of microalbuminuria in Korean patients with type 2 diabetes mellitus.