Angiotensin I-Converting Enzyme Gene Polymorphism Is Associated With Myocardial Infarction, but Not With Retinopathy or Nephropathy, in NIDDM
- Tomomi Fujisawa, MD,
- Hiroshi Ikegami, MD,
- Gong-Qing Shen, MD,
- Eiji Yamato, MD,
- Kiyoshi Takekawa, MD,
- Yusuke Nakagawa, MD,
- Yoichi Hamada, MD,
- Hironori Ueda, MD,
- Hiromi Rakugi, MD,
- Jitsuo Higaki, MD,
- Mitsuru Ohishi, MD,
- Kenshi Fujii, MD,
- Masakatsu Fukuda, MD and
- Toshio Ogihara, MD
- Department of Geriatric Medicine, Osaka University Medical School
- Sakurabashi-Watanabe Hospital, Osaka Teishin Hospital Osaka, Japan
- Department of Ophthalmology, Osaka Teishin Hospital Osaka, Japan
- Address correspondence and reprint requests to Hiroshi Ikegami, MD, Department of Geriatric Medicine, Osaka University Medical School, 2–2 Yamadaoka, Suita, Osaka 565, Japan.
Abstract
OBJECTIVE To clarify the relationship between the angiotensin I-converting enzyme (ACE) gene polymorphism and diabetic micro- and macroangiopathy in patients with non-insulin-dependent diabetes mellitus (NIDDM).
RESEARCH DESIGN AND METHODS We examined 267 NIDDM patients with various stages of diabetic retinopathy, 61 patients with myocardial infarction (MI), and 136 patients without MI. An insertion/deletion polymorphism of the ACE gene was typed by polymerase chain reaction.
RESULTS Although no association was found between ACE gene polymorphism and diabetic retinopathy or nephropathy, this polymorphism was associated with MI in the patients with NIDDM. Homozygotes for the deletion polymorphism (DD genotype) were found more frequently in diabetic patients with MI (31.1%) than in diabetic patients without ischemic heart disease (16.9%), with a relative risk of 2.22 (95% confidence interval 1.11–4.46, P = 0.024).
CONCLUSION These data indicate that ACE gene polymorphism is associated with MI, but not with retinopathy or nephropathy, in patients with NIDDM and suggest that the ACE gene confers susceptibility to diabetic macroangiopathy but not to microangiopathy.
- Received November 15, 1994.
- Revision received March 2, 1995.
- Accepted March 2, 1995.
- Copyright © 1995 by the American Diabetes Association
