Deletion polymorphism of the angiotensin converting enzyme gene is associated with an increase in left ventricular mass in men with type 2 diabetes mellitus

Previous studies evaluating the angiotensin converting enzyme (ACE) gene in sertion/deletion (I/ D) polymorphism have revealed that expression of the D D genotype is associated with an increase in myocardial infarction, cardiom yopathy, and left ventricular (LV) mass in nondiabetic patients. In the pre sent study, a cross-sectional analysis was performed to evaluate the potent ial relationship between the ACE I/D genotypes and the LV mass index in 289 non-insulin-dependent diabetes mellitus (NIDDM) subjects without known cor onary artery disease. Two dimensional directed M-mode echocardiograms along with selected patient characteristics were obtained from the study populat ion. The distribution of the I/D polymorphism was as follows: 63 were II (2 2%), 137 were ID (47%), and 89 were DD (31%). Univariately, the DD genotype was associated with an increase in LV mass in men but not in women. When s ubjected to a multiple regression model that included age, systolic blood p ressure, duration of diabetes, duration of hypertension, presence of the bl ack race, and the presence of the DD genotype, the DD genotype was independ ently associated with an increase in the LV mass index with a parameter est imate of 10.5 g/m(2) (95% CI = 3.9, 17.0; P < .002) in the male subjects. T hus, in this NIDDM study population, male patients with the DD genotype are independently associated with an increased LV mass. (C) 1999 American Jour nal of Hypertension, Ltd.