Purpose:
This study investigated the influence of angiotensin-1
converting enzyme (ACE) insertion-deletion (ID) gene
polymorphism on the treatment responses of type 2
diabetic subjects at varying stages of nephropathy to
ACE inhibitors (ACEI) with regard to blood pressure
(MAP) and renal response (GFR).
Methods:
The pharmacological effect of ACE inhibition on mean
arterial pressure (MAP) and glomerular filtration rate (GFR)
were observed among a total of 62 subjects for a
short-term duration of 15 months. MAP and GFR were
calculated by standard mathematical formulae while the
ACE ID genotype was determined using triple primer PCR.
The general linear model repeated measures were applied
to study the modulation of ACE inhibition on these
parameters.
Results: ACE ID
genotyping of the 62 subjects showed that 19 (30.6 %)
subjects had the II genotype, while 35 (56.4 %) subjects
showed ID genotype and 8 (12.9 %) subjects had the DD
genotype. Significant mean MAP reduction (p < 0.05) and
null mean GFR changes (p > 0.05) from baseline values
were observed among the subjects following
antihypertensive treatment. However, when stratified
according to ACE genotypes, no significant mean MAP and
GFR changes were observed between genotypes following
antihypertensive treatment (p > 0.05).
Conclusion:
ACE ID gene polymorphism does not determine the
treatment efficacy of ACE inhibitors in the Malaysian
population.
Keywords:
ACE genotype, ACE
inhibitor, Type 2 diabetes mellitus, Diabetic
nephropathy
