Insertion-deletion polymorphism in the gene for angiotensin-converting enzyme is associated with obstetric cholestasis but not with preeclampsia

OBJECTIVE: Our purpose was to investigate the contribution of angiotensin-c onverting enzyme insertion-deletion polymorphism in the development of obst etric complications. STUDY DESIGN: In a retrospective case-control study, angiotensin-converting enzyme insertion-deletion polymorphism was investigated in a control group of healthy women (n = 115) and in a group of women diagnosed with preeclam psia (n = 133) and obstetric cholestasis (n = 57). Polymerase chain reactio n detection of insertion-deletion polymorphism was used to determine the pr esence of the two angiotensin-converting enzyme alleles in the groups; the frequencies in the general population in our area are presented for compari son. RESULTS: The frequency of the D allele was 43.9% among women with obstetric cholestasis and 27% among healthy fertile women, which is close to the rat e in the general population in our area (28%). The odds ratio for obstetric cholestasis associated with the DD genotype was 2.12 (95% GI, 1.08-4.12) c ompared with the pooled II and ID genotypes (P = .03). Neither the ID genot ype distributions nor the allele frequencies differed significantly between preeclamptic and normotensive pregnancies (P = .36). CONCLUSION: The present data indicate that the DID genotype is a genetic ma rker associated with an elevated risk of obstetric cholestasis, but this po lymorphism of the angiotensin-converting enzyme gene is unlikely to play an y significant role in preeclampsia.