Key result
The ACE DD genotype was associated with higher mean 24-h diastolic BP (73.8 vs 70.2 and 69.7 mmHg; P=0.005) in normotensive, normoalbuminuric children and adolescents with Type 1 diabetes.
Why the study?
Is the ACE DD genotype associated with 24-h blood pressure abnormalities in normoalbuminuric children and adolescents with Type 1 diabetes?
Observational (n=244)
Is the ACE DD genotype associated with 24-h blood pressure abnormalities in normoalbuminuric children and adolescents with Type 1 diabetes?
Absolute Event Rate: 73.8% vs 70.2%
p-value: p=0.005
The ACE DD genotype is associated with higher 24-hour diastolic blood pressure and reduced diurnal variation in normotensive, normoalbuminuric children and adolescents with Type 1 diabetes.
Should not yet change BP monitoring in normoalbuminuric youth with Type 1 diabetes; hypothesis-generating for ACE DD in early risk stratification.
AIMS: To assess the distribution of the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in children and adolescents with Type 1 diabetes and to evaluate the association between ACE genotype and blood pressure (BP). METHODS: ACE genotypes were assessed in 124 normoalbuminuric, clinically normotensive Type 1 diabetic children and adolescents and 120 non-diabetic controls using polymerase chain reaction. Twenty-four-hour ambulatory BP monitoring was undertaken in all patients. RESULTS: ACE genotypes distributed in patients as follows: 34 (27%) DD, 57 (46%) ID, 33 (27%) II. The distribution was similar in the control group: DD in 28% (33), ID in 45% (54), and II in 27% (33). Patients with DD genotype had higher mean 24-h diastolic BP (73.8 +/- 6.2 vs. 70.2 +/- 5.0 and 69.7 +/- 6.3 mmHg; P = 0.005) and lower diurnal variation in BP (11.8 +/- 4.6 vs. 14.2 +/- 4.2 and 14.8 +/- 4.3%; P = 0.011) compared with ID and II groups. Four patients in the DD group proved to be non-dipper compared with one in the ID and none in the II group (P = 0.026). Twenty-four-hour diastolic blood pressure was independently predictive for AER as dependent variable in the DD genotype patient group (r(2) = 0.12, P = 0.03). CONCLUSIONS: Children and adolescents with Type 1 diabetes do not differ from the non-diabetic population regarding the I/D polymorphism of the ACE gene. ACE gene polymorphism is associated with BP abnormalities in normotensive and normoalbuminuric children and adolescents with Type 1 diabetes.
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Barkai et al. (2005) conducted an observational in Type 1 diabetes (n=244). ACE DD genotype vs. ACE ID and II genotypes was evaluated on Mean 24-h diastolic blood pressure (p=0.005). The ACE DD genotype was associated with higher mean 24-h diastolic BP (73.8 vs 70.2 and 69.7 mmHg; P=0.005) in normotensive, normoalbuminuric children and adolescents with Type 1 diabetes.
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