Angiotensin I converting enzyme gene polymorphism and insulin resistance in patients with angina pectoris

The association between insertion/deletion polymorphism of the angiotensin I converting enzyme (ACE) gene and insulin resistance (IR) was investigated in 64 consecutive patients (F/M: 11/53) with angina pectoris without clini cally manifest diabetes mellitus who underwent diagnostic coronary angiogra phy. The observed frequency distribution of ACE-ID genotypes did not deviat e from that predicted from the Hardy-Weinberg equilibrium in this group. Pa tients with the ACEID genotype had significantly lower IR, as assessed by a n oral glucose tolerance test (OGTT) and by homeostatic model assessment (H OMA), compared to those with the ACE-II genotype, as assessed by a multiple comparison analysis. Patients were divided into two groups with low and hi gh HOMA-IR, and the I allele was seen more frequently in the high HOMA-IR g roup than in the low HOMA-IR group (0.62 v 0.47, respectively, by chi(2) te st, P < .05). Logistic regression analysis showed that the odds ratio for i nsulin resistance in patients with the II genotype, compared to those with the ID and DD genotypes (assuming that the I allele has a recessive effect) , was 4.0 (95% confidence interval, 1.2 to 16.5; P = .037), after adjusting for the presence of significant coronary atherosclerosis. In conclusion, t he D allele was not associated with higher insulin resistance in patients w ith angina pectoris; that is, patients with the ID and DD genotypes were as sociated with a significantly lower risk of insulin resistance, compared to those with the II genotype. Am J Hypertens 1999;12:291-297 (C) 1999 Americ an Journal of Hypertension, Ltd.