The Association of ACE Insertion/Deletion Polymorphisms with Type 2 Diabetes Mellitus and Hypertension

Abstract

Background: Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia and various complications, including diabetic nephropathy, neuropathy, and retinopathy. Hypertension is a common comorbidity in DM patients, exacerbating cardiovascular risks. The Renin-Angiotensin-Aldosterone System (RAAS) plays a significant role in regulating blood pressure and has been linked to both hypertension and type 2 diabetes mellitus (T2DM). The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism is a notable genetic variant within RAAS that may influence susceptibility to these conditions.

Objective: To investigate the association between the ACE I/D polymorphism and the prevalence of hypertension in patients with T2DM.

Methods: This study included 30 patients with diagnosed T2DM and hypertension from MGM Medical College, Navi Mumbai. Genotyping for the ACE I/D polymorphism was performed using polymerase chain reaction (PCR). Clinical parameters such as fasting blood sugar, postprandial blood sugar, glycated haemoglobin (HbA1c), and lipid profiles were assessed. The genotypes were categorized into I/I, I/D, and D/D, and their associations with clinical parameters were analysed.

Results: The distribution of ACE genotypes among the subjects was 77% ID and 23% DD. The ID genotype was significantly associated with higher levels of fasting blood sugar (170.4 ± 54.5 mg/dL vs. 109.5 ± 11.1 mg/dL, p=0.003), postprandial blood sugar (261 ± 74.9 mg/dL vs. 174.1 ± 33.5 mg/dL, p=0.003), and HbA1c (7.8 ± 1.0% vs. 6.7 ± 0.6%, p=0.004) compared to the DD genotype. Although no significant differences were observed in age, BMI, or blood pressure between the genotypes, ID genotype carriers exhibited more pronounced derangements in lipid profiles compared to DD carriers.

Conclusion: The ACE I/D polymorphism is strongly associated with hypertension in T2DM patients. Specifically, the ID genotype correlates with elevated fasting blood glucose, postprandial blood glucose, and HbA1c levels. These findings suggest that the ID genotype may increase susceptibility to hypertension and diabetes-related complications. Further research with larger sample sizes is needed to confirm these associations and explore their implications for personalized treatment strategies.