Abstract

It is known that metabolic disorders of uric acid (UA), in particular hyperuricemia (HU), are associated with vascular complications of type 2 diabetes mellitus (DM 2). Previously, the authors established a relationship between the I/D polymorphism of the angiotensin-converting enzyme (ACE) gene and vascular lesions in patients with DM 2 living in Chuvashia. It was of interest to find out how the I/D polymorphism of the ACE gene and metabolic disorders of MC in patients with diabetes mellitus 2 (residents of Chuvashia) are related. ACE gene polymorphism was determined by the I/D polymerase reaction method in 104 patients with diabetes mellitus 2, in 46 of whom UA metabolism was studied in depth. The UA was determined spectrophotometrically in the blood and in daily urine, and the total and fractional renal clearance of the UA was calculated. There were no significant differences in the parameters of UA metabolism depending on the I/D polymorphism. A steady tendency towards a decrease in renal UA clearance was established in the DD genotype. In patients with the DD genotype in comparison with carriers of the I allele (genotypes ID and DD), a lower mean value of UA clearance was recorded (M 10.0, Me 8.4 ml/min versus M 12.4, Me 11.7 ml/min; Z=1.1, p=0.28) and a higher prevalence of its low (<9 ml/min) values: 60% (9 out of 15) versus 34.6% (9 out of 26) (χ2=2, 18, p=0.14). It should be assumed that with an increase in the number of examined patients, the relationship of the DD genotype with a reduced UA clearance will acquire statistical significance. With the DD genotype, according to many authors, the maximum ACE activity is rectified. The authors suggest that an increase in ACE activity contributes to a decrease in UA transit through the kidneys in the DD genotype

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