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May 1, 1994Diabetes

Genetic Predisposition to Diabetic Nephropathy: Evidence for a Role of the Angiotensin I–Converting Enzyme Gene

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Key result

Carriers of the Xba I/Dde I '+ =' haplotype at the ACE locus had a significantly increased risk of developing diabetic nephropathy (OR 4.0; 95% CI 1.5-11.0).

Why the study?

Are ACE gene polymorphisms associated with an increased risk of diabetic nephropathy in patients with insulin-dependent diabetes mellitus?

Population

151 insulin-dependent diabetes mellitus patients with a diabetes duration of 16-21 years, including 74 cases…

Comparison

Angiotensin I-converting enzyme gene… vs Normoalbuminuric control subjects.

Design

Case-control

Authors

ADAlessandro DoriaJoslin Diabetes CenterJWJames H. WarramBoston UniversityAKAndrzej S. KrólewskiJoslin Diabetes Center

Discussion

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Implication

Cautions against routine ACE genotyping in diabetes; leaves open replication and prospective validation of nephropathy risk.

Study Design

Type

Case-Control (n=151)

Structured PICO

Are ACE gene polymorphisms associated with an increased risk of diabetic nephropathy in patients with insulin-dependent diabetes mellitus?

P
Population
151 patients with insulin-dependent diabetes mellitus for 16-21 years, comprising 74 cases with nephropathy and 77 normoalbuminuric controls.
E
Exposure
Angiotensin I-converting enzyme (ACE) gene polymorphisms (Dde I restriction fragment-melting polymorphism and Xba I insertion/deletion).
C
Comparator
Normoalbuminuric control subjects (albumin excretion rate < 30 micrograms/min).
O
Outcome
Diabetic nephropathy (ranging from microalbuminuria to overt proteinuria).surrogate

Main Result

Odds Ratio: 4 (95% CI 1.5–11)

Specific ACE gene polymorphisms, particularly the Xba I/Dde I '+ =' haplotype, are associated with a significantly increased risk of developing diabetic nephropathy in patients with insulin-dependent diabetes mellitus.

Cite This Study

Doria et al. (1994) conducted a case-control in Diabetic nephropathy in insulin-dependent diabetes mellitus (n=151). Xba I/Dde I '+ =' haplotype at the ACE locus vs. Non-carriers was evaluated on Diabetic nephropathy (OR 4.0, 95% CI 1.5-11.0). Carriers of the Xba I/Dde I '+ =' haplotype at the ACE locus had a significantly increased risk of developing diabetic nephropathy (OR 4.0; 95% CI 1.5-11.0).

synapsesocial.com/papers/6a1ff64ec1b320180d0db324https://doi.org/10.2337/diab.43.5.690

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1DNA polymorphisms in the ACE gene, serum ACE activity and the risk of nephropathy in insulin-dependent diabetes melitus1998 · 25 citations
  2. 2Angiotensin I-converting enzyme gene polymorphisms1998 · 42 citations
  3. 3Association between Angiotensin-Converting Enzyme Gene Polymorphisms and Diabetic Nephropathy2007 · 73 citations
  4. 4Lack of Association Between the Insertion/Deletion Polymorphism of the Angiotensin-Converting-Enzyme Gene and Diabetic Nephropathy in IDDM Patients1998 · 18 citations
  5. 5ACE Insertion/Deletion gene polymorphism and genomic sequence in Diabetic nephropathy2019 · 4 citations