Background: Type 2 diabetes mellitus is an increasing problem in developed countries. Microvascular diabetic complications can lead to worsening of the quality of life and lifespan shortening of diabetic patients. The renin-angiotensin system (RAS) seems to play an important role in microvascular blood flow. I/D polymorphism of angiotensin I converting enzyme (ACE) affecting activity of RAS may contribute to development of microvascular diabetic complications.
Aim: The aim of the study was to evaluate association between I/D polymorphism of ACE gene and presence of microangiopathic complications in type 2 diabetic patients.
Material and methods: 108 type 2 diabetic patients (70 men and 38 women), mean age 60.0 +/- 9.1 years with mean duration of diabetes 9.1 +/- 6.7 years were assessed for presence of microvascular complications (nephropathy, retinopathy, peripheral neuropathy). Subjects were examined for metabolic control of diabetes, lipid profile and degree of insulin resistance based on HOMA rate. I/-D ACE gene polymorphism was evaluated using polymerase chain reaction (PCR).
Results: Diabetic nephropathy was diagnosed in 44 patients (42.7%), retinopathy in 34 patients (31.8%), and peripheral neuropathy in 58 patients (53.7%). Microvascular complications were found (at least one complication) in 83 patients (76.9%). Patients with microangiopathy and without microangiopathy were characterized by similar distribution of I/D ACE gene polymorphism. In carriers of DD ACE genotype blood pressure and HDL-cholesterol serum concentrations were higher than in patients with II polymorphism.
Conclusions: 1. The ACE genotype is not associated with the presence of microvascular complications in type 2 diabetic patients. 2. In type 2 diabetic patients there is an association between DD genotype and higher blood pressure and serum HDL-cholesterol level.