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Link between ACE I/D gene polymorphism and dyslipidemia in diabetic nephropathy: A case-control study from Hyderabad, India

1 Department of Genetics, Osmania University, Hyderabad, Telangana, India
2 Department of Zoology, Maulana Azad National Urdu University, Hyderabad, Telangana, India
3 Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
4 Department of Zoology, Osmania University, Hyderabad, Telangana, India

Correspondence Address:
Parveen Jahan,
Department of Zoology, Maulana Azad National Urdu University, Hyderabad - 500 032, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_244_18

Introduction: Diabetic nephropathy (DN) is the commonest single cause of end-stage renal failure, and dyslipidemia is a critical risk factor in the occurrence of DN. In the light of recent reports emphasizing the importance of angiotensin I-converting enzyme (ACE) in the modulation of plasma lipids, we sought to evaluate the influence of ACE I/D gene polymorphism with dyslipidemia status among type 2 diabetic (T2D) patients with and without nephropathy in the genetic predisposition and the progression to DN. Method: This study comprised of 600 subjects, which include patients with DN, T2D, and healthy controls (HC). Polymerase chain reaction based genotyping of ACE I/D polymorphism was performed and appropriate statistical analysis was done.Results: Out of the 600 subjects, 20 (10%) of the HC, 73 (36.5%) of the T2D group, and 125 (62.5%) of the DN subjects had dyslipidemia. The D allele (0.62) and DD (42.5) genotype frequencies were higher in the DN group in comparison with T2D and HC (P < 0.05). The genotypes also varied among patients with dyslipidemia (χ2 5.04; P < 0.05) but not in the non-dyslipidemia group. Under the co-dominant model, DD genotype conferred a risk of 1.26 (P < 0.001) toward DN, whereas the ID genotype offered protection from DN among the dyslipidemic subjects (OR = 0.05; P < 0.01). In addition, genotype-dependent difference was seen in the plasma lipid levels among study groups. A multiple logistic regression analysis revealed male gender, BMI, HbA1c, TG, HDL, and ACE DD genotype as independent risk factors for the development of DN. Conclusion: The study showed a significant predisposing association of ACE DD genotype with DN and protective effect of ID genotype on DN in the dyslipidemia subgroup.

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Indian Journal of Nephrology
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Online since 20th Sept '07