Abstract
Objective: Diabetic kidney disease DKD (Diabetic nephropathy DN) is considered one of the chronic micro vascular complications of diabetes mellitus and considered the commonest cause leading to chronic renal failure and chronic renal dialysis. Genetic susceptibility has been implicated in DKD. The angiotensin converting enzyme (ACE) is one of the key roles in the renin angiotensin system cascade by converting angiotensin I to angiotensin II which plays a key role in regulation of blood pressure as well as electrolytes and fluid balance. This study addressed the association of (ACE) gene polymorphisms with DN in Egyptian (T2DM) patients. Methods: Our research comprised of 75 cases of T2DM with diabetic kidney disease, 100 cases of T2DM without DKD and 94 healthy volunteers. Different genotypes of ACE gene were determined by SSP-PCR analysis. Results: Gene polymorphism of ACE (DD, ID, II) in diabetic patient with DKD is 44%, 52%, 4% respectively and for T2DM individuals without DKD is 23%, 72%, 5% respectively. (DD) had significant higher frequencies in T2DM patients with DKD compared to those without DKD (p < 0.005) and (ID) had significant higher frequencies in T2DM without DKD (p < 0.0001). These results indicated that there is an association between ACE gene polymorphisms and susceptibility of diabetic patients to be affected by diabetic kidney disease. Conclusion: From our results, we can conclude that genotype of ACE in Egypt DD is the genotype of cases diabetic kidney disease. So the presence of D allele has a significant relation with diabetic kidney disease. Our data confirm the role of ACE in its relationship with diabetic kidney disease in Egyptian type 2 diabetic patients.
Highlights
Diabetic kidney disease diabetic kidney disease (DKD) (Diabetic nephropathy DN) is a clinical syndrome characterized by persistent albuminuria (>300 mg/d or >200 μg/min) that is confirmed on at least 2 occasions 3 - 6 months apart, progressive decline in the glomerular filtration rate (GFR) and elevated arterial blood pressure [1].Diabetic kidney disease is considered one of the most common causes for chronic renal failure and chronic hemodialysis [2]
Comparing studied cases of type 2 diabetes mellitus DN (T2DM) with nephropathy to that of T2DM without nephropathy regarding the gene polymorphism of angiotensin converting enzyme (ACE) and alleles (Table 3, Figure 1 and Figure 2) showed that cases of T2DM with DKD had a statistically significant lower frequencies of the ID genotype and I allele compared to cases of T2DM without DKD (52.0% vs. 72.0%, p < 0.0001 and 30.0% vs. 41.0%, p < 0.045 respectively) while they had a significantly very high frequency of the different grades of albuminuria (DD) genotype and D allele (44.0% vs. 23.0%, p < 0.005 and 70.0% vs. 59.0%, p < 0.045 respectively)
Comparing cases albuminuria >300 with those 300 have high frequency of DD genotype (45.2% vs. 30%, OR = 1.93, p = 0.75)
Summary
Diabetic kidney disease DKD (Diabetic nephropathy DN) is a clinical syndrome characterized by persistent albuminuria (>300 mg/d or >200 μg/min) that is confirmed on at least 2 occasions 3 - 6 months apart, progressive decline in the glomerular filtration rate (GFR) and elevated arterial blood pressure [1]. Diabetic kidney disease is considered one of the most common causes for chronic renal failure and chronic hemodialysis [2]. DKD was considered one of the micro vascular complications in diabetic individuals and one of the leading causes of high mortality among patients with diabetes [3]. There are different etiologies that carry major and a key role that affects onset and progression of DKD, of these factors genetic predisposition and environmental circumstances.
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