Angiotensin I Converting Enzyme Gene Polymorphism in Type 2 Diabetes Mellitus with Nephropathy in Saudi Population

Diabetic Nephropathy (DN) is a major microvascular complication in Type 2 diabetes mellitus (T2DM). Several environmental and genetic factors play a pivotal role in the development and pathogenesis of DN. The angiotensin-converting enzyme (ACE) gene insertion (I)/deletion (D) polymorphism is one of the various genetic factors associated with DN. This study was undertaken to assess the frequency and distribution of ACE I/D polymorphism in T2DM with and without nephropathy patients and controls.

We conducted a case-control study. In a population of 61 patients suffering from T2DM without nephropathy and 61 patients T2DM with nephropathy along with the 52 age matched controls in Saudi populations. ACE I/D polymorphism was detected by PCR amplification using allele specific primers and some biochemical and behavioral markers were monitored. Chi-square and multiple logistic regression analyses were done to determine the odds ratio for development of nephropathy.

The observed genotype frequencies of II, ID and DD in T2DM with nephropathy were 8.2%, 34.4% and 57.4%, in T2DM without nephropathy 16.4%, 44.2% and 39.4%, in control 30.8%, 48.1%, 21.1% respectively. The DD genotype of the T2DM with nephropathy group was higher than the T2DM without nephropathy patients (OR=2.075, 95% CI: 1.008–4.272, p=0.047).

The study illustrated that significant association was observed between the D allele, DD genotype of the ACE gene polymorphism and T2DM with nephropathy in Al-Quwayiyah region of Saudi Arabia. We suggest potential and new multi-property of ACE inhibitors therapy for the prevention or delay of progression of nephropathy.