JOP. J Pancreas (Online) 2001; 2(2):83-87.

Association between ACE Gene Polymorphism and Diabetic Nephropathy in South Indian Patients

Vijay Viswanathan1, Yanqing Zhu2, Karthik Bala2, Stephen Dunn2, Chamukuttan Snehalatha1, Ambady Ramachandran1, Muthu Jayaraman1, Kumar Sharma2

1Diabetes Research Centre. Madras, India. 2Division of Nephrology, Dorrance Hamilton Research Laboratories, Department of Medicine, Thomas Jefferson University. Philadelphia, USA

Objective To study the association of ACE gene polymorphism and diabetic nephropathy in South Indian subjects.

Setting Outpatient clinic of a specialized hospital.

Patients The study included 109 South Indian type 2 diabetic patients (72 males and 37 females; age 56.7ą9.0 years, meanąSD). The patients were subdivided into two groups: nephropathic (n=86) and normoalbuminuric patients (n=23).

Interventions Genomic DNA was isolated from the peripheral blood leukocytes. To determine the ACE genotype, genomic DNA was amplified by PCR initially using a flanking primer pair and, subsequently when necessary, with a primer pair that recognizes the insertion specific sequence for confirmation of the specificity of the amplification reactions.

Main outcome measures ACE genotype distribution in the two study groups.

Results In the nephropathic patients, ID and DD genotypes were present in 52.3% and 27.9% of the patients, respectively as compared to 34.8% and 21.7% respectively in those with normoalbuminuria. The D allele was present in 80.2% of the nephropathic patients and 56.5% of the normoalbuminuric patients (c 2=4.28, P=0.039; odds ratio 3.12). Therefore, the higher percentage of II genotype in the normoalbuminuric group was 43.5% as compared to the 19.8% in nephropathic patients.

Conclusions This study showed a positive association between the D allele (ID and DD genotype) of the ACE polymorphism and diabetic proteinuria in South Indian type 2 diabetic patients. Our findings are in keeping with several earlier studies showing a strong association of the D allele of the ACE gene with diabetic nephropathy.

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  1. Mather HM, Chaturvedi N, Kehely AM. Comparison of prevalence and risk factors for microalbuminuria in South Asians and Europeans with type 2 diabetes mellitus. Diabet Med 1998; 15:672-7. [More details]

  2. Burden AC, Mc Nally PG, Fee Gally J, Walls J. Increased incidence of end stage renal failure secondary to diabetes mellitus in Asian ethnic groups in the United Kingdom. Diabet Med 1992; 9:641-5. [More details]

  3. Kennon B, Petrie JR, Small M, Connell JMC. Angiotensin-converting enzyme gene and diabetes mellitus. Diabet Med 1999; 60:448-58. [More details]

  4. Doi Y, Yoshzimi H, Yoshinari M, Lion K, Yamamoto M, Ichikawa K, et al. Association between a polymorphism in the angiotensin-converting enzyme gene and microvascular complication in Japanese patients with NIDDM. Diabetologia 1996; 39:97-102. [More details]

  5. Miller SA, Dykes DD, Polesky HF. A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res 1988; 16:1215. [More details]

  6. Yoshida H, Kuriyama S, Atsumi Y, Tomonari H, Mitarai T, Hamaguchi A, et al. Angiotensin I converting enzyme gene polymorphism in non-insulin dependent diabetes mellitus. Kidney Int 1996; 50:657-64. [More details]

  7. Shanmugam V, Sell KW, Saha BK. Mistyping of ACE heterozygotes. PCR Methods Appl 1993; 3:120-21. [More details]

  8. Ohno T, Kawazu S, Tomono S. Association analyses of the polymorphisms of angiotensin-converting enzyme and angiotensinogen genes with diabetic nephropathy in Japanese non-insulin-dependent diabetics. Metabolism 1996; 45:218-22. [More details]

  9. Jeffers BW, Estacio RO, Raynolds MV, Schrier RW. Angiotensin-converting enzyme gene polymorphism in non-insulin dependent diabetes mellitus and its relationship with diabetic nephropathy. Kidney Int 1997; 52:473-7. [More details]

  10. Fujisawa T, Ikegami H, Kawaguchi Y, Hamada Y, Ueda H, Shintani M, et al. Meta-analysis of association of insertion/deletion polymorphism of angiotensin I converting enzyme gene with diabetic nephropathy and retinopathy. Diabetologia 1998; 41:47-53. [More details]

  11. Marre M, Jeunemaitre X, Gallois Y, Rodier M, Chatellier G, Sert C, et al. Contribution of genetic polymorphism in the renin-angiotensin system to the development of renal complications in insulin-dependent diabetes: Genetique de la Nephropathie Diabetique (GENEDIAB) study group. J Clin Invest 1997; 99:1585-95. [More details]

Key words Diabetes Mellitus, Non-Insulin-Dependent; Diabetic Nephropathies; India; Peptidyl-Dipeptidase A; Polymorphism (Genetics)

Correspondence Vijay Viswanathan: dr_vijay@vsnl.com