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Role of angiotensin converting enzyme and angiotensinogen gene polymorphisms in angiotensin converting enzyme inhibitor-mediated antiproteinuric action in type 2 diabetic nephropathy patients

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World Journal of Diabetes 2017年第3期8卷 112-119页

作者： Neerja Aggarwal Pawan Kumar Kare Parul Varshney Om Prakash Kalra Sri Venkata Madhu Basu Dev Banerjee Anil Yadav Alpana Raizada Ashok Kumar Tripathi Department of Medicine University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital Department of Biochemistry University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital Pt. B. D. Sharma University of Health Sciences

AIM To investigate the role of genetic variants of angiotensin converting enzyme(ACE) and angiotensinogen(AGT) genes in the antiproteinuric efficacy of ACE inhibitor therapy in diabetic nephropathy(DN) *** In the present study, 270 type 2 diabetes mellitus patients with nephropathy were enrolled and treated with ACE inhibitor(ramipril) and followed at 6 mo for renal function and albumin excretion by estimating serum creatinine, end stage renal disease, and albumin/creatinine ratio(ACR) in urine. Genotyping of ACE I/D and AGT M235 T polymorphisms were performed by using primer specific polymerase chain reaction(PCR) and PCR-RFLP techniques, respectively. RESULTS Forty-eight percent of DN patients(responders) benefited with respect to proteinuria from ACE inhibitor therapy at 6 mo follow-up. A significant reduction in ACR was observed after 6 mo treatment with ACE inhibitor irrespective of whether DN patients were micro-albuminuric(≥ 30 and therapy. A reduction in urinary ACR was found independent of genotypes of ACE I/D and AGT M235 T polymorphisms although macro-albuminuric patients having TT genotype showed statistically insignificant increased response(72%). CONCLUSION ACE inhibitor therapy reduced urinary ACR by ≥ 30% in 50% of DN patients and the response is independent of ACE I/D and AGT M235 T polymorphisms.

关键词： Diabetic nephropathy angiotensin converting enzyme inhibitor therapy Renin-angiotensin-aldosterone system gene polymorphisms Responder Urinary albumin/creatinine ratio Albuminuria

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