The ACE DD genotype was associated with significant odds ratios for coronary heart disease, myocardial infarction, and renal disease, though specific quantitative estimates were not reported.
Meta-Analysis
Does the ACE gene insertion/deletion polymorphism impact susceptibility to cardiovascular and renal disease in patients with diabetes mellitus?
The ACE DD genotype is associated with increased susceptibility to coronary heart disease, myocardial infarction, and renal disease, and may identify individuals resistant to ACE inhibitors.
AIMS: The association of the insertion/deletion polymorphism in the angiotensin-converting enzyme (ACE) gene with cardiovascular disease and diabetic nephropathy remains a controversial issue. This review aims to give an overview of the research to date assessing the impact of the ACE polymorphism in Type 1 and Type 2 diabetes mellitus (DM). METHODS: A systematic review of the literature was performed in the databases of MEDLINE, PubMed and EMBASE for the key words 'diabetes mellitus', 'diabetic nephropathy', 'ACE polymorphism' and 'genotype' and relevant articles were considered. RESULTS: A meta-analysis assessing the influence of the ACE polymorphism on disease susceptibility demonstrated significant odds ratios in individuals with the DD genotype for coronary heart disease, myocardial infarction and both diabetic and nondiabetic renal disease. No association was found for left ventricular hypertrophy or hypertension in nondiabetic subjects. CONCLUSIONS: The ACE polymorphism appears to have a significant impact on the progression of diabetic nephropathy and may have therapeutic implications for identifying those individuals resistant to the effects of ACE inhibitors. It also appears to be indicative of an increased vascular risk in diabetic patients; however, larger prospective studies are required to clarify this situation.
Kennon et al. (Tue,) conducted a meta-analysis in Type 1 and Type 2 diabetes mellitus. ACE gene insertion/deletion polymorphism (DD genotype) was evaluated on Disease susceptibility (coronary heart disease, myocardial infarction, and renal disease). The ACE DD genotype was associated with significant odds ratios for coronary heart disease, myocardial infarction, and renal disease, though specific quantitative estimates were not reported.