ANGIOTENSIN-I - CONVERTING-ENZYME GENE POLYMORPHISM MODULATES THE CONSEQUENCES OF IN-UTERO GROWTH-RETARDATION ON PLASMA-INSULIN IN YOUNG-ADULTS

In utero growth retardation has been linked to a reduced rate of cell division in the fetal organs that undergo rapid growth and to permanen t changes and adaptations (programming) that may affect the physiology in adult life, In particular, in raters growth retardation as reflect ed by a low birth weight for gestational age has been shown to be asso ciated with a relative insulin resistance in adults, How programming m ay influence glucose metabolism is not completely understood, and the possible role of genetic factors has not been explored, The angiotensi n I-converting enzyme gene insertion/deletion (ACE I/D) polymorphism m ay predispose to insulin resistance and modulate the expression of sev eral common cardiovascular and renal disorders, especially in people w ith diabetes. The possible impact of this polymorphism on plasma gluco se and insulin levels was investigated in a group of young adults born at term whose length or weight at birth were in the lowest 3% of the sex anal gestational age-adjusted distribution (SGA, n = 172) and a gr oup of control individuals born with an appropriate birth weight for g estational age (AGA, n = 207). In this study, we have previously demon strated an association between SGA and relative insulin resistance, es pecially in those with shorter gestational age, In the SGA group, fast ing plasma glucose and insulin levels were significantly correlated (R = 0.196, P < 0.015), with this association being significant only in ACE II individuals (R = 0.539, P < 0.0009), In the AGA group, fasting plasma glucose and insulin levels were not significantly correlated. C onsistent with this observation, the relationship between the ACE poly morphism and the insulin response to a glucose load was significantly heterogeneous between the AGA and SGA groups (P < 0.05); this was due to a tendency for ACE LIH individuals in the SGA group to exhibit incr eased 30-min plasma insulin levels (a < 0.05), In the SGA group, there was a significant interaction between gestational age and genotype on the insulin area (P < 0.0004); this index was inversely associated wi th gestational age in ACE II (P < 0.0005) and ACE ID (P < 0.005) subje cts, but not in DD homozygotes (P > 0.05), The ACE D allele may thus a ttenuate the additive consequences of SGA and relatively short duratio n of gestation on insulin resistance in young adults.