ASSOCIATION BETWEEN A POLYMORPHISM IN THE ANGIOTENSIN-CONVERTING ENZYME GENE AND MICROVASCULAR COMPLICATIONS IN JAPANESE PATIENTS WITH NIDDM

The relationship between diabetic nephropathy and an insertion (I)/del etion (D) polymorphism in intron 16 of the angiotensin-converting enzy me (ACE) gene is still under debate. The association of ACE gene polym orphism with nephropathy and retinopathy was therefore examined in 362 Japanese patients with non-insulin-dependent diabetes mellitus (NIDDM ) and 105 healthy control subjects. Distribution of the ACE genotype d id not differ between healthy control subjects and diabetic patients w ithout complications. However, the frequency of the D allele was signi ficantly higher in the diabetic subjects with nephropathy than in thos e without (0.32 in normoalbuminuric patients vs 0.44 in albuminuria pa tients with albuminuria) (chi(2) = 7.7; p = 0.006). There was no signi ficant association between ACE genotype and retinopathy. These observa tions thus demonstrate a significant association of the ACE gene polym orphism with nephropathy, but not with retinopathy, in Japanese patien ts with NIDDM.