Angiotensin-converting enzyme gene insertion/deletion polymorphism and decline of renal function in elderly

doi:10.16150/j.1671-2870.2019.02.016

Abstract

Abstract:

Objective: ACE is the key enzyme of renin-angiotension-aldosterone system(RAAS). The insertion (I allele) deletion (D allele) polymorphism of ACE gene determines the serum level of ACE. There are three genotypes including DD, ID and II. The aim of this study was to study the possible impact of this polymorphism on risk of renal function decline in Chinese elderly people. Methods: A total of 366 elderly patients from geriatrics department of Ruijin Hospital in 2010 was enrolled. Medical history (hypertension and diabetes) was collected, weight and the basic clinical characteristics were measured. Polymerase chain reaction (PCR) was used to determine the ACE genotypes (ID, II, DD). Patients were followed up in 2011 and 2016. After excluding the dead and those lost to follow-up, 152 cases were remained for analysis. These patients were divided into two groups according to the ACE genotypes, the group DD+ID and the group II. Results: Retrospective analysis showed that the 6 years follow-up demonstrated a trend of decline of weight and creatinine clearance rate(Ccr)(P<0.05) and a trend of rising of fast blood glucose level(P<0.05). There were no significant differences in fast blood lipid level, the incidence of diabetes and hypertension(P>0.05). There were no significant differences between group DD+ID and group II for weight, sex, age, fast blood glucose level, fast blood lipid level, incidence of diabetes and hypertension (P>0.05). Group DD+ID had more decline of Ccr than group II(P<0.05). Conclusions: The D allele of ACE gene is a risk factor of decline of kidney function in Chinese elderly people.

Key words: Angiotensin converting enzyme, Gene polymorphism, Renal function, Elderly

CLC Number:

R692.5

WU Lin, ZHENG Ge, TAO Ting. Angiotensin-converting enzyme gene insertion/deletion polymorphism and decline of renal function in elderly[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(2): 204-208.

Figures/Tables 6

References 16

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参数	2011年	2017年	P值
体重（kg）	68.70±9.73	65.74±10.42	0.011
空腹血糖（mmol/L）	5.27±0.99	5.61±1.40	0.014
三酰甘油（mmol/L）	1.58±1.02	1.44±0.60	0.147
总胆固醇（mmol/L）	4.89±0.97	4.71±1.02	0.117
低密度胆固醇脂蛋白（mmol/L）	2.74±0.77	2.57±0.28	0.090
高密度胆固醇脂蛋白（mmol/L）	1.33±0.29	1.31±0.35	0.452
尿素氮（mmol/L）	5.90±1.70	6.10±1.90	0.171
肌酐（mmol/L）	99.54±30.53	90.26±28.72	0.208
内生肌酐清除率（mL/min）	60.93±19.54	53.84±20.00	0.002
糖尿病发病率（%）	27.6	37.5	0.066
高血压发病率（%）	45.4	55.9	0.066

基因型	基因型频率观察值	基因型频率预测值	χ²值	P值
DD	15(9.9%)	15(9.8%)
ID	64(42.1%)	65(42.8%)	0.029	0.804
II	73(48.0%)	72(47.4%)

参数	ID+DD组 (n=79)	II组 (n=73)	P值
性别(男/女)	70/9	64/9	0.674
年龄（岁）	76.75±7.78	78.44±7.14	0.166
体重（kg）	69.63±9.05	67.71±10.40	0.225
空腹血糖（mmol/L）	5.22±0.78	5.32±1.18	0.532
三酰甘油（mmol/L）	1.64±0.74	1.72±1.26	0.634
总胆固醇（mmol/L）	4.88±0.92	4.90±1.09	0.907
低密度脂蛋白胆固醇（mmol/L）	2.96±0.76	2.73±1.01	0.123
高密度脂蛋白胆固醇（mmol/L）	1.35±0.27	31±0.44	0.552
高血压发病率（%）	49.4	41.1	0.306
糖尿病发病率（%）	31.6	23.3	0.211

参数	ID+DD组 (n=79)	II组 (n=73)	P值
体重（kg）	65.80±9.93	65.67±11.00	0.937
空腹血糖（mmol/L）	5.55±1.13	5.69±1.63	0.544
三酰甘油（mmol/L）	1.45±0.62	1.43±0.58	0.870
总胆固醇（mmol/L）	4.71±1.18	4.71±0.83	0.997
低密度脂蛋白胆固醇（mmol/L）	2.60±0.98	2.54±0.78	0.707
高密度脂蛋白胆固醇（mmol/L）	1.29±0.33	1.33±0.37	0.521
高血压发病率（%）	57.0	54.8	0.788
糖尿病发病率（%）	40.5	34.6	0.426

指标	ID+DD组 (n=79)	II 组 (n=73)	P值
尿素氮（mmol/L）
基线	5.80±1.40	5.85±2.08	0.859
6年后	6.28±1.78	6.57±1.26	0.556
6年后与基线比较的差值	0.47±1.44	0.69±2.49	0.647
肌酐（mmol/L）
基线	93.08±18.80	96.14±39.58	0.539
6年后	91.32±14.60	97.30±32.77	0.619
6年后与基线比较的差值	-1.76±28.76	-1.16±43.07	0.751
内生肌酐清除率（mL/min）
基线	62.91±19.487	58.80±19.501	0.196
6年后	54.05±20.535	53.60±19.529	0.889
6年后与基线比较的差值	-8.85±10.03	-5.20±10.32	0.028