Higher prevalence of deletion allele in angiotensin converting enzyme gene among type 2 diabetic subjects with lower estimated glomerular filtration rate

Introduction: Chronic Kidney Disease (CKD) is associated with a high risk of developing further severe complications such as, cardiovascular disease and eventually End Stage Renal Disease (ESRD) leading to death. The aim of the study was to determine the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in different stages of chronic kidney disease (CKD) among subjects with type 2 diabetes (T2DM). Methods: A total of 226 subjects with T2DM were screened for the study and classified into two groups based on estimated Glomerular filtration rate (eGFR). Those with eGFR ≥60 ml/min/1.73 m2 (Group 1: n =109, M: F, 73:36) and those with eGFR <60 ml/min/1.73 m2 (Group 2: n=117 M: F, 64:53). ACE genotyping was performed using Polymerase Chain Reaction. Results: The genotypic and allelic frequency of group 1 was II 52(47.7%), ID 47 (43.1%), DD 10(9.2%), I 151 (69.3%), D 67 (30.7%) and group 2 was II 13 (11.1%), ID 76 (65%), DD 28(23.9%), I 102 (43.6%), D 132 (56.4%) respectively. The OR (95% CI) for ID and DD genotype between the groups were 6.4 (3.2-13.1) p<0.001 and 11.2 (4.4-28.8) p<0.001 respectively after adjusting with gender, age and Body Mass Index. The genotypic frequency was also compared between genders. The OR (95% CI) for male was ID 3.1(1.3-7.4), DD 6.1(1.7-12.4), and female was ID 5.3(1.3-4.5), DD 8.8 (3.0-10.7) Conclusion: The ID and DD genotype of ACE gene confers a greater role in genetic variations underlying high risk stage of CKD especially in women subjects.