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ACE gene polymorphism and diabetic complications: is there a connection?
1Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland. bk8h@clinmed.gla.ac.uk
Summary
The ACE gene insertion/deletion polymorphism influences diabetic nephropathy progression. Individuals with the deletion allele (DD genotype) face faster disease advancement and poorer outcomes, suggesting a need for targeted therapies.
Area of Science:
- Genetics
- Endocrinology
- Nephrology
Background:
- The ACE gene's I/D polymorphism significantly impacts serum ACE levels.
- Its role in diabetic complications and cardiovascular disease requires further clarification.
Purpose of the Study:
- To systematically review the literature on ACE gene polymorphism's impact on diabetic complications.
- To assess its implications for treatment strategies.
Main Methods:
- Systematic review of Medline, Pubmed, and EMBASE databases (1966-August 1999).
- Keywords included 'diabetes mellitus', 'diabetic nephropathy', 'ACE gene polymorphism', and 'genotype'.
Main Results:
- ACE gene polymorphism appears to influence diabetic nephropathy progression.
- Individuals with the DD genotype show a faster progression from microalbuminuria to renal replacement therapy and reduced survival.
- No association was found between ACE gene polymorphism and diabetic retinopathy.
Conclusions:
- The deletion allele of the ACE gene may act as a susceptibility factor in diabetic nephropathy progression.
- ACE genotyping could identify high-risk individuals for early, aggressive treatment.
- Further large prospective studies are needed to confirm these associations.
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