PMID- 10023638
OWN - NLM
STAT- MEDLINE
DCOM- 19990223
LR  - 20190815
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 33
IP  - 2
DP  - 1999 Feb
TI  - Effect of ACE gene on diabetic nephropathy in NIDDM patients with insulin 
      resistance.
PG  - 276-81
AB  - We investigated the influence of the angiotensin-converting enzyme (ACE) gene on 
      the onset and/or progression of diabetic nephropathy in 62 Japanese patients with 
      non-insulin-dependent diabetes mellitus (NIDDM; type II diabetes). Because a 
      number of factors are believed to be involved in the onset and/or progression of 
      diabetic nephropathy, especially in patients with NIDDM, we selected the patients 
      with well-matched risk factors, duration of disease, glycemic control, blood 
      pressure, and others. All patients had normal renal function and none were 
      receiving ACE inhibitors. Patients were divided into three groups according to 
      albumin excretion rate (AER): group A, patients with an AER less than 15 
      microg/min (n = 29); group B, patients with an AER between 15 and 70 microg/min 
      (n = 19); and group C, patients with an AER greater than 70 microg/min (n = 14). 
      The glucose disposal rate was estimated using a euglycemic hyperinsulinemic 
      clamp. We determined the mean glucose disposal rate in 132 patients with NIDDM 
      (6.49 mg/kg/min). Patients with a glucose disposal rate less than the mean rate 
      were considered to have a high degree of insulin resistance (n = 36). The 
      presence of an insertion/deletion (I/D) polymorphism of the ACE gene was 
      determined by the polymerase chain reaction method. Among patients with a high 
      degree of insulin resistance, diabetic nephropathy was present in 2 of 11 
      patients with the II genotype of the ACE gene compared with 19 of 25 patients 
      with the ID or DD genotype (P = 0.0024). The prevalence of diabetic nephropathy 
      was greater in patients with both significant insulin resistance and the D allele 
      (19 of 25) than in the remaining patients (14 of 37; odds ratio, 5.20). These 
      results suggest that the ACE gene influences the onset and/or progression of 
      diabetic nephropathy in patients with NIDDM with significant insulin resistance.
FAU - Kuramoto, N
AU  - Kuramoto N
AD  - Department of Internal Medicine II, Chiba University School of Medicine, Japan.
FAU - Iizuka, T
AU  - Iizuka T
FAU - Ito, H
AU  - Ito H
FAU - Yagui, K
AU  - Yagui K
FAU - Omura, M
AU  - Omura M
FAU - Nozaki, O
AU  - Nozaki O
FAU - Nishikawa, T
AU  - Nishikawa T
FAU - Tsuchida, H
AU  - Tsuchida H
FAU - Makino, H
AU  - Makino H
FAU - Saito, Y
AU  - Saito Y
FAU - Kanatsuka, A
AU  - Kanatsuka A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - EC 3.4.15.1 (Peptidyl-Dipeptidase A)
SB  - IM
MH  - Diabetes Mellitus, Type 2/blood/complications/*physiopathology
MH  - Diabetic Nephropathies/blood/etiology/*physiopathology
MH  - Female
MH  - Glucose Clamp Technique
MH  - Humans
MH  - *Insulin Resistance
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Peptidyl-Dipeptidase A/*genetics
MH  - Polymorphism, Genetic
EDAT- 1999/02/19 00:00
MHDA- 1999/02/19 00:01
CRDT- 1999/02/19 00:00
PHST- 1999/02/19 00:00 [pubmed]
PHST- 1999/02/19 00:01 [medline]
PHST- 1999/02/19 00:00 [entrez]
AID - S0272-6386(99)70300-8 [pii]
AID - 10.1016/s0272-6386(99)70300-8 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 1999 Feb;33(2):276-81. doi: 10.1016/s0272-6386(99)70300-8.