Association between ACE gene polymorphism and diabetic nephropathy in South Indian patients.
Association between ACE gene polymorphism and diabetic nephropathy in South Indian patients.
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发表时间：
2001-03
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通讯作者：
V. Viswanathan;Y. Zhu;K. Bala;S. Dunn;C. Snehalatha;Ambady Ramachandran;M. Jayaraman;K. Sharma
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作者：
V. Viswanathan;Y. Zhu;K. Bala;S. Dunn;C. Snehalatha;Ambady Ramachandran;M. Jayaraman;K. Sharma
目的探讨血管紧张素转换酶(ACE)基因多态性与南印度人群糖尿病肾病的关系。设置专科医院门诊部。研究对象包括109名南印度2型糖尿病患者(男性72名，女性37名；年龄56.7岁加/减9.0岁，平均加/减SD)。将患者分为肾病组(86例)和正常白蛋白尿组(23例)。干预从外周血白细胞中提取基因组DNA。为了确定ACE基因型，首先使用侧翼引物对基因组DNA进行扩增，然后在必要时使用识别插入特定序列的引物对进行扩增，以确认扩增反应的特异性。主要观察指标ACE基因在两个研究组中的分布。结果肾病患者ID和DD基因频率分别为52.3%和27.9%，而正常白蛋白尿组分别为34.8%和21.7%。D等位基因在肾病患者中的频率为80.2%，在正常白蛋白尿患者中的频率为56.5%(卡方检验=4.28，P=0.039；优势比3.12)。因此，正常白蛋白尿组中II型的比例较高，为43.5%，而肾病患者为19.8%。结论血管紧张素转换酶基因D等位基因(ID和DD)与南印度2型糖尿病患者的糖尿病蛋白尿呈正相关。我们的发现与早期的几项研究一致，这些研究表明ACE基因的D等位基因与糖尿病肾病有很强的相关性。
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 56.7 plus/minus 9.0 years, mean plus/minus SD). 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 (chi-squared=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.