Distribution of Angiotensin Converting Enzyme I/D Polymorphism in Diabetic and Diabetic Nephropathy Patients at a Tertiary Care Hospital in Maharashtra.

摘要

Background: Diabetes Mellitus (DM) is one of the leading non-communicable disorders, leading to various complications viz. cardiovascular diseases, retinopathy, nephropathy, neuropathy and peripheral vascular disorders. Diabetic Nephropathy (DN) patients further develop into End Stage Renal Disease (ESRD) and they have to undergo the repeated blood transfusions, increasing the social and economic burden. The number of risk factors are known for causation of diabetic nephropathy including the environmental, biochemical as well as genetic factors. The association of nephropathy with various genes has been proved. Aim and Objectives: In the present study we attempted to check the association of Insertion/Deletion (I/D) polymorphism of Angiotensin Converting Enzyme (ACE) in diabetic patients with and without nephropathy and also with the biochemical markers. Material and Methods: Each group consisted of 110 individuals viz. diabetics with and without nephropathy and age and gender matched healthy controls. Results: The determination of I/D polymorphism by polymerase chain reaction revealed the significant increased 'D' allele frequencies in patients of diabetes with and without nephropathy than the controls, while no significant difference was noted in genotype frequencies. The odds ratios for this polymorphism were calculated to be 1.84 and 2.41 for DM and DN respectively in comparison with the healthy controls. The regression analysis indicated I/D polymorphism is associated positively with all the lipid parameters, except High Density Lipoprotein- Cholesterol (HDL-C) which was negatively associated with the polymorphism. The levels of lipid parameters were also significantly increased in patients of diabetes with and without nephropathy carriers for 'D' allele than the patients having 'I' allele, while the level of HDL-C was significantly decreased. Conclusion: The conclusion can be made from these results that, the presence of I/D polymorphism of ACE may increase the risk of development of nephropathy in general population, with the role of 'D' allele in its causation, along with its effect on the biochemical markers.