The Relationship Between Angiotensin Converting Enzyme Gene Polymorphism And Diabetes Mellitus In Hypertensive Patients

Objectives To study the association between angiotensin converting enzyme(ACE) gene polymorphisms and diabetes mellitus in hypertensive patients.Methods All the subjects in this study were recruited from healthy people in Kailuan.300 hypertensive patients complicated with diabetes mellitutas and 300 hypertensive patients were randomly recruited as case group and control group respectively.Demographic data, the human body measurements including height, weight, waist circumference, hip circumference, blood pressure and the biochemical indexes were collected by questionnaire investigation and experimental measurement. Polymerase chain reaction and restriction fragment length polymorphism methods were used to determine the genotype of ACE gene I/D polymorphism, rs4293 polymorphism and rs4333 polymorphism. The chi-square test was used to compare the distribution of the three polymorphisms between case group and control group. Multiple Logistic regression was used to analyze the effect of ACE gene polymorphisms on diabetes mellitus in hypertensive patients.Results 1 The difference of age, DBP, HDL were not significant between case group and control group(all P>0.05). The difference of gender, BMI, SBP, TG, LDL, TC, Fbg, ALT were significantly between case group and control group(all P<0.05). 2 The proportion of patients with rs4293 GG genotype in case group(11%) was significantly higher than that in control group(1%). There was no difference for distribution of rs4293 allele frequency between case group and control group. The genotype distribution of ACE gene I/D polymorphism and rs4333 polymorphism had no statistical difference between two groups.3 After corrected the sex, age, BMI, TG, HDL and LDL, TC, ALT variables using Logisic regression analysis, patients with rs4293 GG type had higher risk of diabetes mellitus than those with AA type(OR = 7.392, 95% CI 2.076 ~ 16.318, P < 0.05). There has no association of the I/D polymorphism(II vs ID: OR = 1.397, 95% CI 0.808 ~ 2.415, P >0.05; II vs ID: OR = 1.324, 95% CI 0.670 ~ 2.614, P > 0.05) and rs4333 polymorphism(TT vs CT: OR = 1.267, 95% CI 0.692~2.317; TT vs CT: OR = 1.013, 95% CI 0.555~1.851) with diabetes mellitus in hypertensive patients. Age, BMI, TG, LDL, ALT were risk factors for diabetes mellitus in patients with hypertension. Female maybe a protection factor for diabetes mellitus in patients with hypertension.5 Using linear regression method to analyze relationship between the polymorphisms of ACE gene and the glucose level, the result showed that after correcting the influence factors such as gender, age and so on,there had no relationship between I/D polymorphism, rs4293 polymorphism, rs4333 polymorphism and the glucose levels.Conclusions 1 Rs4293 SNP of ACE gene was associated with the risk of diabetes mellitus in patients with hypertenstion, patients with GG genotype had higher risk ofdiabetes mellitus than those with AA genotype. 2 There has no association of the I/D polymorphism and rs4333 polymorphism with diabetes mellitus in hypertensive patients.