Key result
The presence of the D allele was independently associated with higher levels of ACE activity compared to the II genotype.
Why the study?
Does the presence of the D allele correlate with higher ACE activity in macroalbuminuric type 2 diabetic patients under chronic ACE inhibition?
Observational (n=121)
Does the presence of the D allele correlate with higher ACE activity in macroalbuminuric type 2 diabetic patients under chronic ACE inhibition?
The D allele of the ACE genotype is associated with higher ACE activity in type 2 diabetic patients with macroalbuminuria despite chronic ACE inhibition, suggesting a genetic modulation of treatment effect.
Answers are grounded in this paper and cite their sources.
May suggest variable ACE inhibitor response by genotype in diabetic nephropathy; hypothesis-generating and requires prospective trials before clinical use.
The activity of the renin-angiotensin-aldosterone system (RAAS) plays an important role in the development and progression of diabetic nephropathy. However, the effect of angiotensin-converting enzyme (ACE) inhibition on the RAAS appears to be modulated by a number of factors including the I/D polymorphism of the ACE genotype. In this study, we attempted to find independent correlates of ACE activity in 121 macroalbuminuric type 2 diabetic Iranian patients under chronic ACE inhibition. Both univariate and multivariate analyses were used. The presence of the D allele was independently associated with significantly higher levels of ACE activity (with the II genotype as reference, P < 0.001, B = 27.3, 95% CI = 17.6-37.1), and this association was not eliminated by potentially confounding variables. In conclusion, the D allele is a significant independent correlate of ACE activity in macroalbuminuric type 2 diabetic Iranian patients under long-term ACE inhibition.
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Nikzamir et al. (2007) conducted an observational in Macroalbuminuric type 2 diabetes (n=121). Presence of the D allele (ACE I/D polymorphism) vs. II genotype was evaluated on ACE activity (B = 27.3, 95% CI 17.6-37.1, p=<0.001). The presence of the D allele was independently associated with higher levels of ACE activity compared to the II genotype.
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