Why the study?
Does ACE I/D polymorphism affect circulating levels of PAI-1, D-dimer, usCRP, and TGF-β1 in patients undergoing hemodialysis?
Cross-Sectional (n=138)
Yes
Does ACE I/D polymorphism affect circulating levels of PAI-1, D-dimer, usCRP, and TGF-β1 in patients undergoing hemodialysis?
p-value: p=0.033
In hemodialysis patients, the ACE D allele is associated with higher PAI-1 levels, potentially increasing cardiovascular risk, while the I allele is linked to greater interdialytic weight gain.
Hypothesis-generating in hemodialysis; leaves open whether ACE genotyping refines cardiovascular risk or fluid management.
BACKGROUND: There is substantial evidence that chronic renal and cardiovascular diseases are associated with coagulation disorders, endothelial dysfunction, inflammation and fibrosis. Angiotensin-Converting Enzyme Insertion/Deletion polymorphism (ACE I/D polymorphism) has also be linked to cardiovascular diseases. Therefore, this study aimed to compare plasma levels of ultrassensible C-reactive protein (usCRP), PAI-1, D-dimer and TGF-β1 in patients undergoing HD with different ACE I/D polymorphisms. METHODS: The study was performed in 138 patients at ESRD under hemodialysis therapy for more than six months. The patients were divided into three groups according to the genotype. Genomic DNA was extracted from blood cells (leukocytes). ACE I/D polymorphism was investigated by single polymerase chain reaction (PCR). Plasma levels of D-dimer, PAI-1 and TGF-β1 were measured by enzyme-linked immunosorbent assay (ELISA), and the determination of plasma levels of usCRP was performed by immunonephelometry. Data were analyzed by the software SigmaStat 2.03. RESULTS: Clinical characteristics were similar in patients with these three ACE I/D polymorphisms, except for interdialytic weight gain. I allele could be associated with higher interdialytic weight gain (P = 0.017). Patients genotyped as DD and as ID had significantly higher levels of PAI-1 than those with II genotype. Other laboratory parameters did not significantly differ among the three subgroups (P = 0.033). Despite not reaching statistical significance, plasma levels of usCRP were higher in patients carrying the D allele. CONCLUSION: ACE I/D polymorphisms could be associated with changes in the regulation of sodium, fibrinolytic system, and possibly, inflammation. Our data showed that high levels of PAI-1 are detected when D allele is present, whereas greater interdialytic gain is associated with the presence of I allele. However, further studies with different experimental designs are necessary to elucidate the mechanisms involved in these associations.
No takes yet. Share an insight, caveat, or question.
Carvalho et al. (2016) conducted a cross-sectional in End-stage renal disease (ESRD) undergoing hemodialysis (n=138). ACE I/D polymorphism (D allele) vs. II genotype was evaluated on Plasma levels of PAI-1 (p=0.033).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: