ACE gene polymorphism and serum ACE level with Progression of Nephropathy in Type 2 Diabetic Patients

Heba Mourad Yousif,Mie Afify,Esmat Ashour,Weaam Gouda,Manal Fouad Ismail,Olfat Gamil Shaker

doi:10.24297/jac.v9i3.1009

Abstract

Background. One of the most common complications of diabetes mellitus (DM) is diabetic nephropathy (DN). Angiotensin- converting enzyme (ACE) gene was the first candidate gene of renin-angiotensin system (RAS) for predisposition to DN.Objective. Investigation whether the ACE insertion/deletion (I/D) polymorphism is associated with Egyptian type 2 diabetic patients (T2DM) with nephropathy. In addition, the study investigated the relationship between variants of ACE I/D gene polymorphism and serum ACE level and the progression of nephropathy in Egyptian T2DM patients.Methods. A total of 85 T2DM patients (45 with nephropathy and 40 without nephropathy) besides 45 healthy (non-diabetic) age-matched subjects were recruited in this study for comparison. The (I/D) polymorphism of the ACE gene was investigated using PCR and serum ACE levels were determined using ELISA.Results. The frequency of ACE DD genotype and D allele was significantly higher in DN patients when compared to control healthy subjects and diabetic patients without nephropathy. In addition our results showed a significant association between DD genotype of ACE gene and elevated serum ACE level.Conclusion. The present study showing a strong association between the D allele and/or DD homozygous of ACE gene and diabetic patients developed nephropathy. In addition, individuals with D allele have higher levels of serum ACE compared to those having I allele. ACE gene polymorphism and serum ACE level may serve as a susceptibility biomarker for nephropathy in type 2 diabetic patients.

Highlights

One of the most common complications of diabetes mellitus (DM) is diabetic nephropathy (DN), a progressive and irreversible kidney disease that occurs because of DM [1]
The frequency of Angiotensin- converting enzyme (ACE) DD genotype and D allele was significantly higher in DN patients when compared to control healthy subjects and diabetic patients without nephropathy
In addition our results showed a significant association between DD genotype of ACE gene and elevated serum ACE level

Summary

Introduction

One of the most common complications of diabetes mellitus (DM) is diabetic nephropathy (DN), a progressive and irreversible kidney disease that occurs because of DM [1]. In Egypt the prevalence of nephropathy ranged from 6.7% in hospital outpatient clinics to 46.3% in hospital inpatients [2]. Diabetic nephropathy (DN) is characterized by a progressive increase in proteinuria, declining glomerular filtration rate (GFR) and an elevation of arterial blood pressure [3; 4]. The pathogenesis of diabetic nephropathy is not yet clearly understood, but available data suggest that multiple factors contribute to this complication. Studies of familial clustering suggest that genetic predisposition plays a role in the development of diabetic nephropathy [6]. One of the most common complications of diabetes mellitus (DM) is diabetic nephropathy (DN). Angiotensin- converting enzyme (ACE) gene was the first candidate gene of renin-angiotensin system (RAS) for predisposition to DN

Results

Discussion

Conclusion