I am very grateful to Costa et al. (1) for their letter in this issue of Diabetes Care , because their findings give me the opportunity to clarify several important points. Our recent paper (2) associated ACE gene insertion/deletion (I/D) polymorphism with metabolic syndrome (MS) in Chinese type 2 diabetic patients. Although Costa et al. showed a similar prevalence of MS in Brazilian type 2 diabetic patients, they did not find any association between ACE gene I/D polymorphism and MS. While we believe their findings are interesting, we do not believe that they can be used to support their claim that our findings came about by chance. The prevalence of MS in patients with type 2 diabetes among different ethnic populations could not be evaluated and compared until MS was defined by the World Health …
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