Objectives: Increased plasma angiotensin-converting enzyme 2 (ACE2) levels are associated with cardiovascular risk in diabetes and therapeutic targets. ACE2 is an endogenous regulator of the renin-angiotensin system and is important in various cardiovascular diseases (CVDs). This study aimed to investigate the association between increased ACE2 levels and cardiovascular risk in patients with type 2 diabetes mellitus (T2DM), particularly those with CVD. Materials and Methods: In this cross-sectional study, subjects were classified into 3 groups. Each Group has 87 individuals. Group I was considered as controls, Group II was considered as diabetes, and Group III was considered as diabetes with heart disease who attended the master health checkup, cardiology and general medicine OP in the tertiary care centre. The serum ACE, ACE2, oxidized-low-density lipoprotein (ox-LDL), and highly sensitive c-reactive were examined using the enzyme-linked immunosorbent assay technique, and the lipid levels were measured using the AU 480 (Auto analyser). Results: The study found that mean plasma ACE, ACE2, ACE/ACE2 ratio, ox-LDL, and high-sensitivity-C-reactive protein (hs-CRP) levels were significantly higher in group III than compared to group II and group I (P < 0.001). A significant correlation was observed between ACE2, ACE, ACE/ACE2 ratio, hs-CRP, and ox-LDL in patients with group III. Linear regression analysis showed a strong association of ACE2 with hs-CRP, ox-LDL and ACE. Conclusion: The study concludes that increased ACE2 levels may be associated with the risk of CVD in T2DM, especially in those with coronary heart disease. These findings suggest the possibility of independent risk assessment in diabetic patients.
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