The relationship between ACE genotype and risk of severe hypoglycaemia in a large population-based cohort of children and adolescents with type 1 diabetes
Genetic factors may account for familial clustering related to diabetes complications. Studies have shown a significant relationship between the presence of the deletion (D) allele of the gene encoding ACE and risk of severe hypoglycaemia. This large prospective cohort study assesses this relationship in a large sample of children and adolescents with type 1 diabetes.
Subjects and methods
We studied 585 children and adolescents (mean age 11.9 ± 4 years, 48.4% males). The frequency of severe hypoglycaemia (an event leading to loss of consciousness or seizure) was prospectively assessed over the 13-year period 1992–2004. Patients were seen with their parents every 3 months and data recorded at each visit. The ACE gene was detected using PCR.
In our cohort of 585 children, 186 (31.8%) had at least one episode of severe hypoglycaemia, and of these 28.0% had the II genotype, 48.9% had the ID genotype and 23.1% had the DD genotype. This was in agreement with the Hardy–Weinberg proportion. A total of 477 severe hypoglycaemic episodes was recorded with a total of 3,404 person-years of follow-up, giving a total incidence of 14 per 100 patient-years. No significant increase in risk for DD genotype (incidence rate ratio = 0.97, 95% CI 0.61–1.55) relative to II genotype was observed.
This large prospective study concludes that the presence of the D allele of the ACE gene does not predict a significantly higher risk of severe hypoglycaemia in type 1 diabetic children and adolescents.
- The relationship between ACE genotype and risk of severe hypoglycaemia in a large population-based cohort of children and adolescents with type 1 diabetes
Volume 50, Issue 5 , pp 965-971
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- Angiotensin-converting enzyme
- ACE genotype
- Severe hypoglycaemia
- Type 1 diabetes mellitus
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- Author Affiliations
- 1. School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Nedlands, Perth, WA, 6009, Australia
- 3. Centre for Child Health Research, Telethon Institute of Child Health Research, Perth, WA, Australia
- 5. School of Surgery and Pathology, University of Western Australia, Perth, WA, Australia
- 2. Department of Endocrinology, Princess Margaret Hospital, Perth, WA, Australia
- 4. Clinical Biochemistry, PathWest, Queen Elizabeth II Medical Centre, Perth, WA, Australia
- 6. University of Western Australia Centre for Medical Research and Western Australian Institute for Medical Research, Perth, WA, Australia
- 7. School of Pediatrics and Child Health, University of Western Australia, Perth, WA, Australia