What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy children and adolescents (n=203). Intervention: ACE gene I/D polymorphism vs. Genotypes (DD vs ID vs II) across races. Primary outcome: Serum ACE activity differences between genotypes (p=0.0001).

January 1, 1996

Racial Difference in the Relationship of an Angiotensin I–Converting Enzyme Gene Polymorphism to Serum Angiotensin I– Converting Enzyme Activity

Key Result

The ACE gene I/D polymorphism was significantly associated with serum ACE activity in white children and adolescents (P=0.0001 for DD vs II) but not in black children and adolescents.

Study Design

Type

Cross-Sectional (n=203)

Structured PICO

Does the relationship between ACE gene I/D polymorphism and serum ACE activity differ between white and black children and adolescents?

Population

203 healthy, unrelated children and adolescents (141 white, 62 black), mean age 14.7 years.

Intervention

Assessment of ACE gene insertion (I)/deletion (D) polymorphism

Comparator

Comparison between genotypes (DD, ID, II) and between racial groups (white vs black)

Outcome

Serum ACE activitysurrogate

The ACE gene I/D polymorphism is associated with serum ACE activity in white but not black children and adolescents, highlighting important ethnic variation in genetic regulation.

Main Result

p-value: p=0.0001

Abstract

An insertion (I)/deletion (D) polymorphism of the angiotensin I-converting enzyme (ACE) gene that has been associated with certain cardiovascular disorders accounts for nearly half the variation in serum ACE level in white subjects. Whether a similar association of serum ACE with the I/D polymorphism occurs in other racial groups is not known. We studied the I/D polymorphism of ACE in relation to serum ACE activity in 141 white and 62 black healthy, unrelated children and adolescents (mean age, 14.7 years). The mean level of ACE activity in whites homozygous for the D allele was higher than in heterozygotes (P = .002) and in homozygotes for the I allele (P = .0001), consistent with an earlier study. In blacks, on the other hand, no significant difference in serum ACE activity between genotypes was observed. An additional finding was a significantly positive relationship between serum ACE activity and diastolic pressure (P = .009). In children and adolescents, serum ACE activity is related to the ACE gene I/D polymorphism in whites but not in blacks. The results indicate a potentially important ethnic variation in genetic regulation of serum ACE activity and the relationship of the I/D polymorphism to cardiovascular disease.