Renal outcome and vascular morbidity in systemic lupus erythematosus (SLE): Lack of association with the angiotensin-converting enzyme gene polymorphism

Objectives: The angiotensin-converting enzyme (ACE) gene polymorphism has b een associated with worse outcome in various chronic glomerular disorders a nd in hypertension. Because nephritis and vascular morbidity are prominent determinants of outcome in systemic lupus erythematosus (SLE), we studied t he distribution and prognostic effect the ACE genotype might have on the ou tcome of SLE. Methods: Fifty-six consecutive Israeli SLE patients and 48 (sex and ethnic origin matched) healthy individuals were evaluated for the ACE genotype by a polymerase chain reaction-based assay. The clinical and laboratory parame ters of the patients as well as the SLE disease activity index (SLEDAI) and the presence of hypertension, diabetes mellitus, ischemic heart disease, c ongestive heart failure, and stroke were correlated with the ACE genotype. Results: The distribution of the ACE genotype D/D, D/I, and I/I in the lupu s group was 59%, 36%, and 5%, respectively, similar to the distribution in the control group (54%, 31%, and 15%, respectively). We failed to find any significant association between the ACE genotype and disease manifestations , SLEDAI, renal function, or cardiovascular and cerebrovascular morbidity. The clinical and laboratory parameters associated with renal outcome and va scular morbidity in our cohort are described. Conclusions: No difference was found between the distribution of the ACE ge notype in lupus patients and the general population in Israel. Renal functi on as well as cardiovascular and cerebrovascular morbidity among Israeli pa tients with SLE are disease-related and independent of the ACE gene polymor phism. Copyright (C) 2000 by W.B. Saunders Company.