Key result
The ACE DD genotype was associated with increased peripheral arterial disease risk in type 2 diabetics (OR 2.48; 95% CI 1.18-5.21), with the highest risk in those with traditional risk factors.
Why the study?
Is the ACE gene DD genotype associated with an increased risk of peripheral arterial disease in type 2 diabetic patients, and how do traditional risk factors affect this association?
Observational (n=945)
Is the ACE gene DD genotype associated with an increased risk of peripheral arterial disease in type 2 diabetic patients, and how do traditional risk factors affect this association?
Effect estimate: OR 2.48 (95% CI 1.18-5.21)
The ACE DD genotype is significantly associated with peripheral arterial disease in Taiwanese type 2 diabetic patients, with traditional risk factors further amplifying this risk.
We investigated the effect of traditional risk factors (hypertension, dyslipidemia and smoking) on the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and peripheral arterial disease (PAD) in 945 (454 men and 491 women) Taiwanese type 2 diabetic patients with a mean age of 63.5 (SD: 11.4) years. Among them, 81 (31 men and 50 women) had PAD (ankle-brachial index <0.9). The adjusted odds ratios (95% confidence intervals) were 2.48 (1.18-5.21), 1.69 (1.00-2.85) and 1.64 (1.12-2.39), respectively, for recessive (DD versus II + ID), dominant (DD + ID versus II) and additive (II = 0, ID = 1 and DD = 2) models. While analyzing the interaction between DD and the individual risk factor of hypertension, smoking and dyslipidemia, patients with the risk factor and with DD had the highest risk compared to referent patients without the risk factor and with II/ID. The respective adjusted odds ratios were 5.41 (2.05-14.31), 7.38 (1.87-29.06) and 4.64 (1.70-12.64). We did not find a significant interaction between DD and any of the risk factors under multiplicative or additive scale. In conclusion, traditional risk factors (hypertension, smoking and dyslipidemia) play an important role in the association between ACE genotypes and PAD. Patients with DD genotype and traditional risk factors are at the highest risk.
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Tseng et al. (2011) conducted an observational in Type 2 diabetes and peripheral arterial disease (n=945). ACE gene DD genotype vs. II + ID genotypes was evaluated on Peripheral arterial disease (ankle-brachial index <0.9) (OR 2.48, 95% CI 1.18-5.21). The ACE DD genotype was associated with increased peripheral arterial disease risk in type 2 diabetics (OR 2.48; 95% CI 1.18-5.21), with the highest risk in those with traditional risk factors.
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