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ACE gene polymorphism and progression of diabetic nephropathy in Korean type 2 diabetic patients: effect of ACE gene DD on the progression of diabetic nephropathy.

 Sung-Kyu Ha  ;  Hyeong Cheon Park  ;  Dae Suk Han  ;  Ho Yung Lee  ;  Kyu Hun Choi  ;  Shin Wook Kang  ;  Do Hun Kim  ;  Seung Jung Kim  ;  Hak Jin Hwang  ;  Tae Hee Lee  ;  Byung Seung Kang  ;  Hong Su Park 
 American Journal of Kidney Diseases, Vol.41(5) : 943-949, 2003 
Journal Title
 American Journal of Kidney Diseases 
Issue Date
BACKGROUND: 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 and progression. METHODS: The impact of insertion/deletion (I/D) genotypes on the progression of diabetic nephropathy in 239 Korean patients with type 2 diabetes (99 patients with stable renal function, group 1; 140 patients with declining renal function, group 2) was investigated by retrospective review of clinical data. RESULTS: The frequency of the DD genotype was significantly greater in group 2 compared with group 1 (30.7% versus 9.1%; P < 0.05). There were no significant differences in age, blood pressure, hemoglobin A(1c) levels, or lipid profiles among ACE genotype groups. However, the prevalence of retinopathy was significantly greater in patients with the DD genotype (DD, ID, and II, 90.4%, 71.2%, and 70.6%, respectively; P < 0.05). Patients with the DD genotype reached the end point (serum creatinine > 2.0 mg/dL [176.8 micromol/L]) faster than those with the other genotypes (DD, 11.38 +/- 4.08 years; ID, 13.85 +/- 4.04 years; II, 14.04 +/- 4.06 years, respectively; P < 0.05) and took significantly less time to reach dialysis therapy (DD, 13.10 +/- 4.45 years; ID, 16.21 +/- 4.74 years; II, 15.13 +/- 4.09 years, respectively; P < 0.05). In multiple logistic regression analysis, systolic blood pressure and DD genotype showed significant correlations with the progression of diabetic nephropathy. In patients with the DD genotype, the odds ratio was 3.881 (95% confidence interval, 1.564 approximately 9.628; P = 0.003) compared with those with the II genotype. CONCLUSION: It is suggested that the ACE gene DD genotype might be a significant risk factor for the progression of diabetic nephropathy.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강병승(Kang, Byung Seung)
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
김도훈(Kim, Do Hoon)
박형천(Park, Hyeong Cheon) ORCID logo https://orcid.org/0000-0002-1550-0812
이태희(Lee, Tae Hee)
이호영(Lee, Ho Yung)
최규헌(Choi, Kyu Hun)
하성규(Ha, Sung Kyu)
한대석(Han, Dae Suk)
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