Carotid intima-media thickness and ACE-gene polymorphism in hemodialysis patients

Background: Carotid artery intima-media thickness (CIMT) has been used as a marker of atherosclerosis. An insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is associated,vith various cardio vascular diseases. This study is aimed at evaluating early atherosclerotic involvement of carotid vessels and the relation to known risk factors and A CE gene I/D in hemodialysis (HD) patients. Methods: We measured CIMT using high-resolution B-mode ultrasonography in 5 1 non-diabetic HD patients and in 70 age- and sex-matched healthy controls, and evaluated the factors influencing CIMT. An I/D polymorphism in intron 16 of the gene coding for ACE was analysed by polymerase chain reaction. Results: The mean CIMT was significantly higher in HD patients than in heal thy subjects (p<0.0001). In multiple regression analysis, independent risk factors for increased CIMT in HD patients were predialysis systolic blood p ressure (p<0.001) and ACE D allele (p<0.01). Conclusions: The present data suggest that CIMT is enlarged in IID patients . The ACE gene seems to be a candidate for influencing the CIMT and might t herefore be involved in an HD patient's predisposition to the development o f atherosclerosis.