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June 1, 2009Journal of the Renin-Angiotensin-Aldosterone System

The insertion/deletion polymorphism of the angiotensin-converting enzyme gene is associated with progression, but not development, of albuminuria in Iranian patients with type 2 diabetes

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Key result

The ACE gene D allele independently increased the odds of having macroalbuminuria versus microalbuminuria approximately threefold (p<0.01) in Iranian patients with type 2 diabetes.

Why the study?

Is the ACE gene I/D polymorphism associated with the development and progression of albuminuria in Iranian patients with type 2 diabetes?

Population

322 Iranian patients with type 2 diabetes, categorized into normoalbuminuria, microalbuminuria and…

Comparison

ACE gene I/D polymorphism (D allele) vs ACE gene I/D polymorphism (I allele / II genotype)

Design

Cross-sectional

Authors

ANAbdolrahim NikzamirAhvaz Jundishapur University of Medical SciencesAEAlireza EsteghamatiUniversity of MinnesotaMFMostafa FeghhiAhvaz Jundishapur University of Medical Sciences

Discussion

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Implication

The ACE D allele was associated with macroalbuminuria progression in Iranian T2D; leaves open whether genotyping aids risk stratification pending prospective validation.

Study Design

Type

Cross-Sectional (n=322)

Structured PICO

Is the ACE gene I/D polymorphism associated with the development and progression of albuminuria in Iranian patients with type 2 diabetes?

P
Population
322 Iranian patients with type 2 diabetes categorized by albuminuria status (normoalbuminuria, microalbuminuria, and macroalbuminuria).
E
Exposure
ACE gene I/D polymorphism (D allele)
C
Comparator
ACE gene I/D polymorphism (I allele / II genotype)
O
Outcome
Development (normoalbuminuria to microalbuminuria) and progression (microalbuminuria to macroalbuminuria) of albuminuriasurrogate

Main Result

Odds Ratio: 3

p-value: p=<0.01

In Iranian patients with type 2 diabetes, the ACE gene D allele is associated with the progression to macroalbuminuria, but not the initial development of microalbuminuria.

Cite This Study

Nikzamir et al. (2009) conducted a cross-sectional in Type 2 diabetes (n=322). ACE gene I/D polymorphism (D allele) vs. Non-D allele / other genotypes was evaluated on Progression to macroalbuminuria versus microalbuminuria (OR ~3, p=<0.01). The ACE gene D allele independently increased the odds of having macroalbuminuria versus microalbuminuria approximately threefold (p<0.01) in Iranian patients with type 2 diabetes.

synapsesocial.com/papers/6a9430733fda5c29338c1705https://doi.org/10.1177/1470320309104872
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Also Consider

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

  1. 1Association of angiotensin I-converting enzyme gene polymorphism with susceptibility to antiproteinuric effect of angiotensin I-converting enzyme inhibitors in patients with proteinuria.1995 · 65 citations
  2. 2Excess of DD homozygotes in haemodialysed patients with type II diabetes. The Diabetic Nephropathy Study Group1997 · 62 citations
  3. 3Genetic Predisposition to Diabetic Nephropathy: Evidence for a Role of the Angiotensin I–Converting Enzyme Gene1994 · 186 citations
  4. 4Relationships Between Angiotensin I Converting Enzyme Gene Polymorphism, Plasma Levels, and Diabetic Retinal and Renal Complications1994 · 366 citations
  5. 5Lack of association between the angiotensin-converting enzyme gene (I/D) polymorphism and diabetic nephropathy in Tunisian type 2 diabetic patients2008 · 54 citations