Interaction between angiotensin-converting enzyme genotype and glycaemic control influences lipoprotein levels in Type 2 diabetes mellitus
- 45 Downloads
To evaluate the influence of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on lipid levels in patients with Type 2 diabetes.
Patients and methods
109 patients with Type 2 diabetes were included. The patients were not on any lipid-lowering treatment. The groups with different ACE genotypes had similar ages, sex distributions, body mass indices, systolic blood pressures and indices of glycaemic control. ACE gene I/D polymorphism was determined using polymerase chain reaction.
The mean apolipoprotein B (apoB) level was significantly higher in the group of DD homozygotes compared with the subjects with at least one insertion allele (DD: 1.21±0.25 g/l vs. ID+II: 1.04±0.27 g/l;P=0.007). Significant correlations between glycated haemoglobin (HbA10) and both apoB and cholesterol levels were found (r=0.27;P<0.01). For the apoB, this correlation was highly significant in the DD-genotype subgroup (r=0.54;P<0.01), and was not significant in the subgroup of patients with genotypes ID or II. In the multivariate analysis, HbA10 and the interaction of genotype DD with HbA10 were significant independent predictors of apoB (r2=0.17) and cholesterol levels.
The present study showed that the interaction between the DD genotype of angiotensin-converting enzyme and chronic hyperglycaemia (expressed by HbA10 level) is related to higher plasma levels of atherogenic lipoproteins, such as apoB and cholesterol, in patients with Type 2 diabetes.
KeywordsAngiotensin-converting enzyme polymorphism lipoproteins apolipoprotein B Type 2 diabetes mellitus glycated haemoglobin
Unable to display preview. Download preview PDF.
- 2.Reaven GM (1994) Syndrome X: 6 years later. J Intern Med 736 [Suppl]: 13–22Google Scholar
- 5.Ruiz J, Blanche H, Cohen N, Velho G, Cambien F, Cohen D, et al (1994) Insertion/deletion polymorphism of the angiotensin-converting enzyme gene is strongly associated with coronary heart disease in non-insulin-dependent diabetes mellitus. Proc Natl Acad Sci USA 91: 3662–3665PubMedCrossRefGoogle Scholar
- 7.Barnas U, Schmidt A, Illievich A, Kiener HP, Rabensteiner D, Kaider A, et al (1997) Evaluation of risk for the development of nephropathy in patients with IDDM: insertion/deletion angiotensin converting enzyme gene polymorphism, hypertension and metabolic control. Diabetologia 40: 327–331PubMedCrossRefGoogle Scholar
- 12.Corbo RM, Vilardo T, Mantuano E, Ruggeri M, Gemma AT, Scacchi R (1999) Apolipoproteins B and E, and angiotensin I-converting enzyme genetic polymorphisms in Italian women with coronary artery disease (CAD) and their relationships with plasma lipid and apolipoprotein levels, Hum Biol 71: 933–945PubMedGoogle Scholar
- 14.Nagi DK, Foy CA, Mohamed-Ali V, Yudkin JS, Grant PJ, Knowler WC (1998) Angiotensin-I-converting enzyme (ACE) gene polymorphism, plasma ACE levels, and their association with the metabolic syndrome and electrocardiographic coronary artery disease in Pima Indians. Metabolism 47: 622–626PubMedCrossRefGoogle Scholar
- 15.Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, et al (1998) Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS 23). Br Med J 316: 823–828Google Scholar
- 26.Marian AJ, Safavi F, Ferlic L, Dunn JK, Gotto AM, Ballantyne CM (2000) Interactions between angiotensin-I converting enzyme insertion/deletion polymorphism and response of plasma lipids and coronary atherosclerosis to treatment with fluvastatin. The Lipoprotein and Coronary Atherosclerosis Study. J Am Coll Cardiol 35: 89–95PubMedCrossRefGoogle Scholar
- 27.Mattei MG, Hubert C, Alhenc-Gelas F, Roeckel N, Corvol P, Soubrier F (1989) Angiotensin-I converting enzyme gene is on chromosome 17. Cytogenet Cell Genet 51: 1041Google Scholar
- 28.Haagerup A, Kristensen T, Kruse TA (1991) Polymorphism and genetic mapping of the gene encoding human beta-2-glycoprotein I to chromosome 17. Cytogenet Cell Genet 58: 2005Google Scholar