Angiotensin I-converting enzyme insertion/deletion gene polymorphism and its association with diabetic nephropathy in type-2 diabetes mellitus patients: an Egyptian study

Yasmine M. Amrousy, Department of Clinical and Chemical Pathology, Faculty of Medicine, Helwan UniversityFollow
Tamer M. Soliman, Department of Clinical Pathology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
Haythem A. Tolba, Departments of Nephrology
Aisha Elshimy, Clinical Pathology, National Institute of Urology and Nephrology, Cairo

Article Type

Original Study

Subject Area

Laboratory Medicine

Abstract

Background Diabetic nephropathy (DN) is one of the most serious complications associated with type-2 diabetes mellitus (T2DM). With variable allele and genotype frequencies, the angiotensin I-converting enzyme (ACE) insertion–deletion (I/D) gene polymorphism has been suggested as a risk factor for DN. Objective The purpose of the study was to find whether ACE I/D polymorphism is associated with DN in Egyptian T2DM patients and its relation to ACE concentration and C-reactive protein quantitative level. Participants and methods A case–control study of 98 T2DM patients was divided into two groups: group 1, T2DM patients without DN, and group 2, T2DM patients with DN. The frequencies of the ACE I/D gene polymorphism (I, D allele and DD, ID, II genotype) were compared in the two groups. Results An association was found between D allele, combined II+DD genotype on comparing the two groups (odds ratio 2.029, 95% confidence interval: 1.379–2.985, P≤0.001 and odds ratio 2.039, 95% confidence interval: 1.027–4.048, P=0.042, respectively), ACE-activity level was the highest with DD and the lowest with II genotypes with P value less than 0.001 in all T2DM patients, while ACE I/D polymorphism did not show an association with C-reactive protein level. The multiple logistic-regression analysis revealed ACE-concentration level and combined ACE ID+DD genotype as independent risk factors for the development of DN. Conclusion The study showed a significant predisposing association of D allele and ACE ID+DD genotype with DN and the protective effect of II genotype, and that the DD genotype was associated with the highest ACE concentration.

Keywords

angiotensin-converting enzyme insertion/deletion polymorphism, angiotensin-converting enzyme, C-reactive protein, diabetic nephropathy, type-2 diabetes mellitus

Recommended Citation

Amrousy, Yasmine M.; Soliman, Tamer M.; Tolba, Haythem A.; and Elshimy, Aisha (2023) "Angiotensin I-converting enzyme insertion/deletion gene polymorphism and its association with diabetic nephropathy in type-2 diabetes mellitus patients: an Egyptian study," Journal of Medicine in Scientific Research: Vol. 6: Iss. 2, Article 6.
DOI: https://doi.org/10.59299/2537-0928.1041