Angiotensin Converting Enzyme Gene Insertion/Deletion Polymorphism Is Not Responsible for Antihypertensive Therapy Induced New Onset of Type 2 Diabetes in Essential Hypertension

Abstract

Background:Antihypertensive drug therapies have been reported to be associated with new onset of type 2 diabetes mellitus in some hypertensive patients after prolonged use. Angiotensin converting enzyme (ACE) gene has been found to affect essential hypertension, response of antihypertensive therapies, and glycemic disturbances. Therefore, ACE gene I/D polymorphism may be associated with risk of new onset of type 2 diabetes via metabolic disturbances, glycemic dysregulation, and insulin resistance.Aim:To assess the correlation between ACE gene I/D polymorphism and glycemic disturbance under influence of diuretic and other antihypertensive drug therapies.Materials and methods:We recruited 270 normotensive patients as control (150 men and 120 women), 270 hypertensive patients (95 men and 175 women), and 240 hypertensive with new onset of diabetes patients (80 men and 160 women). All samples were genotyped for ACE gene polymorphic alleles and relationship between different genotypes and anthropometric and clinical parameters along with drug therapies was established and analyzed.Results:Baseline clinical (systolic blood pressure, diastolic blood pressure, and fasting blood glucose level) and anthropometric parameters (height, weight, waist circumference, hip circumference, waist-hip ratio, and body mass index) of study populations were found highly statistically significant (P < .05) when compared among study groups. Furthermore, genotype wise comparison of all these parameters in essential hypertensive (EH) and essential hypertensive with onset of diabetes (EHNOD) patients found most of them nonsignificant and no variation was found with respect to different genotypes of ACE gene. The genotype wise comparison of clinical parameters among different antihypertensive drug therapy was found statistically nonsignificant in both EH and EHNOD patients.Discussion:Anthropometric parameters can be taken as the risk indicator factors for hypertension and diabetes. However, ACE gene polymorphism may not be a risk factor for development of diabetes in hypertensive patients.Conclusion:The present study suggested that ACE gene polymorphism did not show any significant association with the risk of new onset of diabetes in EH patients and more detailed studies with large population size are needed.

Association between angiotensin converting enzyme gene polymorphism and essential hypertension: A systematic review and meta-analysis

“…The remaining 91 articles were subject to a complete full-text assessment, and as a result, 34 articles were excluded due to the following reasons: (1) theoretical research (11); (2) without clinical outcomes (18); (3) repeated articles (2); and (4) lack of a control group (3). We ultimately identified 57 studies 6–62 that met the inclusion criteria of the current meta-analysis, which incorporated a total of 16,298 EH patients in the EH group and 16,564 healthy controls or patients without EH in the control group. Study selection is outlined in Figure 1.…”

Distribution of the ACE Gene Polymorphisms in Type 2 Diabetes Mellitus Patients, Their Associations with Nephropathy Biomarkers and Metabolic Indicators at a Tertiary Hospital in Uganda

“… 12 Another found blood pressure with new onset T2D and essential hypertension to have no association with the ACE I/D polymorphisms. 13 A recent meta-analysis found that ACE I/D polymorphism was associated with insulin-resistant polycystic ovarian syndrome, especially among Asians. 14 It is important to note that the exact relationship between ACE I/D polymorphisms and metabolic indicators could vary depending on several other variables such as population demographics, study design, and other genetic or environmental factors.…”

“… 12 In two separate meta-analyses, Ng et al reported that there was a noticeable protective role of the II genotype against diabetic nephropathy, especially among T2DM patients of Asian (Chinese, Japanese, and Korean) descent compared to Caucasians. 13 , 14 The authors reported that the presence of the ACE II genotype among Asians with T2DM was also associated with a lower risk of macroalbuminuria but was slightly associated with the risk of microalbuminuria. There is limited research that has validated these findings.…”

Detection of the Association between ACE Gene Polymorphism and Lipid Profiles Level in Some Iraqi Hypertensive Patients

“…22 ACE II genotype is associated with a significant decrease in hypertension, in contrast to the DD genotype. 23 ACE I/D polymorphism indirectly affects the regulation of lipids. 24 ACE is connected with some cardiovascular abnormalities such as myocardial infarction, 25 cardiovascular diseases, 26 strokes and coronary heart disease.…”