ANGIOTENSIN I-CONVERTING ENZYME GENE POLYMORPHISM IS ASSOCIATED WITH MYOCARDIAL-INFARCTION, BUT NOT WITH RETINOPATHY OR NEPHROPATHY, IN NIDDM

OBJECTIVE-To clarify the relationship between the angiotensin I-conver ting enzyme (ACE) gene polymorphism and diabetic micro- and macroangio pathy in patients with non-insulin-dependent diabetes mellitus (NIDDM) . RESEARCH DESIGN AND METHODS- We examined 267 NIDDM patients with var ious stages of diabetic retinopathy, 61 patients with myocardial infar ction (MI), and 136 patients without MI. An insertion/deletion polymor phism of the ACE gene was typed by polymerase chain reaction. RESULTS- Although no association was found between ACE gene polymorphism and di abetic retinopathy or nephropathy, this polymorphism was associated wi th MI in the patients with NIDDM. Homozygotes for the deletion polymor phism (DD genotype) were found more frequently in diabetic patients wi th MI (31.1%) than in diabetic patients without ischemic heart disease (16.9%), with a relative risk of 2.22 (95% confidence interval 1.11-4 .46, P = 0.024). CONCLUSION-These data indicate that ACE gene polymorp hism is associated with MI, but not with retinopathy or nephropathy, i n patients with NIDDM and suggest that the ACE gene confers susceptibi lity to diabetic macroangiopathy but not to microangiopathy.