Higher Plasma Glucose Level In Hypertensive Patient With Angiotensin Converting Enzyme Gene Deletion Of Intron 16

Abstract

Background Renin Angiotensin Aldosteron System plays major role in hypertension pathophysiology. Has been proposed that half of individuals with essential hypertension are considered insulin resistant. Angiotensin Converting Enzyme gene polymorphism taking the control of ACE level in human plasma. There might be a correlation between ACE gene polymorphism and plasma glucose level. Objective This study sought to investigate ACE gene polymorphism insertion/deletion in hypertensive patients and its correlation with plasma glucose level. Method A total of 100 hypertensive patients at Saiful Anwar cardiovascular outpatients clinic who received ACEi at least 8 weeks were included. ACE genotype were determined by polymerase chain reaction method, and plasma glucose level was measured by enzymatic colorimetric assay method. Result The II, ID, and DD genotype were observed in 48%, 29% and 23% of participant, respectively. The fasting and 2 hours post prandial plasma glucose were significantly higher in DD genotype patients. The insertion/ deletion polymorphisms were not related significantly to age, sex, cough, and controlled blood pressure of those patients. Conclusion This study showed that 23% of hypertensive patients had DD genotype with higher plasma glucose level as compare to those of II and ID genotype.(J Kardiol Indones. 2016;37:13-8) Latar Belakang : Sistem Renin Angiotensin Aldosteron berperan penting dalam hipertensi. Telah diperkirakan bahwa separuh dari pasien dengan hipertensi primer memiliki resistensi terhadap insulin. Polimorfisme gen Angiotensin Converting Enzyme (ACE) dianggap bertanggung jawab terhadap kadar ACE dalam plasma. Diprediksi terdapat hubungan antara polimorfisme gen ACE dengan tingginya kadar gula pada pasien hipertensi. Tujuan : Mempelajari hubungan antara polimorfisme gen ACE dengan kadar gula darah pada pasien hipertensi. Metode : Sebanyak 100 pasien hipertensi dari Poli Jantung Rumah Sakit dr.Saiful Anwar Malang yang menerima terapi dengan penghambat ACE selama 8 minggu diambil darahnya untuk dianalisis polimorfisme gen ACE serta dilakukan pengukuran kadar gula darah. Hasil : Genotip II, ID, dan DD ditemukan sebesar 48%, 29% and 23% masing-masing Kadar gula darah puasa dan 2 jam sesudah makan lebih tinggi signifikan pada kelompok pasien dengan genotip DD. Sedangkan terhadap usia, jenis kelamin, dan terkontrolnya tekanan darah tidak ditemukan hubungan dengan polimorfisme gen ACE. Kesimpulan: 23% pasien hipertensi dengan genotip DD memiliki gula darah yang lebih tinggi dibanding genotip II dan ID.(J Kardiol Indones. 2016;37:13-8) Kata kunci : gen angiotensin converting enzyme gene, insersi/delesi, kadar gula darah