EVALUATION OF THE INSERTION DELETION ACE GENE POLYMORPHISM AS A RISK FACTOR FOR CAROTID-ARTERY INTIMA-MEDIA THICKENING AND HYPERTENSION IN YOUNG TYPE-1 DIABETIC-PATIENTS/

OBJECTIVE -To study the distribution of the insertion/deletion polymor phism of the ACE gene in young type 1 diabetic patients and to evaluat e possible associations between the ACE genotype, arterial hypertensio n, and intima-media thickness (IMT) of the common carotid artery. RESE ARCH DESIGN AND METHODS -Study participants were 148 type 1 diabetic p atients (56 men and 92 women), aged 14-44 years, with a diabetes durat ion of greater than or equal to 2 years. HbA(1c), albuminuria, and lip id status were assessed by standard laboratory techniques; the ACE gen otypes were assessed by polymerase chain reaction. The patients were c ategorized according to the presence or absence of hypertension, nephr opathy, and retinopathy. The IMT, which can be used to estimate early stages of atherosclerosis, was measured by high-resolution ultrasonogr aphy. RESULTS -The ACE genotypes were distributed as follows: 21% II, 37% ID, 42% DD. The IMT values did not differ among patients with vari ous ACE genotypes (0.63 +/- 0.15 mm), but the prevalence of hypertensi on was significantly higher in patients with DD (odds ratio, 4.26 vers us II + ID; 95% CI, 1.64-11.06). Multiple linear regression analysis s howed that only age, hypertension, and sex were determinants for the I MT. CONCLUSIONS -Our results suggest a relationship between the preval ence of hypertension and the deletion polymorphism of the ACE gene in young type 1 diabetic patients, but we could not find an association b etween carotid artery IMT and ACE genotype in this population.