LACK OF ASSOCIATION BETWEEN THE INSERTION DELETION POLYMORPHISM OF THE ANGIOTENSIN-CONVERTING-ENZYME GENE AND DIABETIC NEPHROPATHY IN IDDM PATIENTS/

The insertion/deletion (I/D) polymorphism of the angiotensin-convertin g-enzyme (ACE) gene has been reported to be associated with diabetic n ephropathy in IDDM, We studied the relationship between this polymorph ism and diabetic nephropathy in 210 IDDM patients. Their DNA was analy zed by polymerase chain reaction to type for the presence (I) or absen ce (D) of the 287 bp fragment in intron 16 of the ACE gene. The relati ve frequency of the different genotypes was 33.8% (DD), 43.8% (ID), an d 22.4% (II). There were no significant differences between the genoty pes in age, body-mass-index, blood pressure, plasma total cholesterol and triglycerides, The prevalence of microalbuminuria or nephropathy w as 23.9% in the DD, 16.3% in the ID, and 17% in the II genotypes, The higher percentage of microalbuminuria or nephropathy in the DD genotyp es was due to an increasing frequency of DD genotypes in the IDDM pati ents with long diabetes duration, After matching for diabetic retinopa thy, gender, and diabetes duration, there was no association between t he ACEI/D polymorphism and diabetic nephropathy, In conclusion, these results suggest that the ACE DD genotype cannot be regarded as a risk factor for diabetic nephropathy, but may even be associated with diabe tes duration and thus longevity in IDDM patients.