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Polymorphism of the ACE Gene in Dialysis Patients: Overexpression of DD Genotype in Type 2 Diabetic End-Stage Renal Failure Patients

 Hyeong Cheon Park  ;  So Rae Choi  ;  Beom Seok Kim  ;  Tae Hee Lee  ;  Byung Seung Kang  ;  Kyu Hyun Choi  ;  Ho Yung Lee  ;  Dae Suk Han  ;  Sung-Kyu Ha 
 YONSEI MEDICAL JOURNAL, Vol.46(6) : 779-787, 2005 
Journal Title
Issue Date
Aged ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/genetics* ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/genetics* ; Female ; Gene Frequency ; Homozygote ; Humans ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/genetics* ; Male ; Middle Aged ; Peptidyl-Dipeptidase A/genetics* ; Peptidyl-Dipeptidase A/metabolism ; Polymorphism, Genetic* ; Renal Dialysis
ACE gene polymorphism ; end-stage renal failure ; type 2 diabetes
The angiotensin-converting enzyme (ACE) gene DD homozygote has been suggested to be a significant risk factor for the progression of diabetic nephropathy. We analyzed clinical parameters and ACE genotype distribution between type 2 diabetic patients at the extremes of renal risk, i.e. an end-stage renal failure (ESRF) group (n = 103, group 1) who were on dialysis therapy due to progression of diabetic nephropathy, and a no progression group (n = 88, group 2) who had maintained normal renal function and normoalbuminuria for more than 15 years. There were no significant differences in age, sex, body mass index, HbA1c level, or lipid profiles between the two groups (p > 0.05). Group 1 had a significantly higher prevalence of hypertension [group 1: 82.5% (85/103) vs. group 2: 50.0% (44/88), p < 0.05] and diabetic retinopathy [group 1: 103/103 (100%) vs. group 2: 28/88 (31.8%), p < 0.05] than group 2. Daily urinary albumin excretion was also higher in group 1 than in group 2 [group 1: 2873 ± 2176 mg/day vs. 12 ± 7 g/day, p < 0.05]. The frequencies of the DD, ID, and II genotypes of the ACE gene in group 1 and group 2 were 26.2%, 47.6%, and 26.2%, and 7.9%, 57.9%, and 34.2%, respectively. The ACE genotype frequencies between the two groups were significantly different according to a chi-square test with Bonferroni's correction (p = 0.004). The presence of the DD genotype increased the risk of ESRF 4.286-fold compared to the II genotype [odds ratio 4.286, 95% CI 1.60-11.42, p = 0.005]. The frequency of the D-allele was higher in both male and female patients in group 1 compared to group 2, but reached statistical significance only in males [male, group 1: 50.8% vs. group 2: 35.0%, p = 0.018, female, group 1: 48.8% vs. group 2: 39.5%, p = 0.231]. This study, although limited by sample size, showed that type 2 diabetic ESRF patients more frequently expressed the DD genotype. These findings may substantiate the previously noted relationship between the ACE DD genotype and the progression of diabetic nephropathy in Korean type 2 diabetic patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Lee, Tae Hee(이태희)
Lee, Ho Yung(이호영)
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Choi, Sorae(최소래)
Ha, Sung Kyu(하성규)
Han, Dae Suk(한대석)
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