不同程度阻塞性睡眠呼吸暂停合并高血压与血管紧张素转换酶基因I/D 多态性的比较研究

目的:评价阻塞性睡眠呼吸暂停(OSA)合并高血压(HT)与血管紧张素转换酶(ACE)基因多态性的关系.方法:采用病例对照研究方法,以OSA的严重程度将研究对象分为正常对照组(68人)、HT组(45人)、轻度OSA合并HT组(27人)、中重度OSA合并HT组(31人),共171例;(2)观察ACE I/D多态在一个OSA典型家系中的分布.结果:(1) ACE I/D等位基因的频率分布如下:中重度OSA合并HT组,I等位基因的频率显著高于其他各组(P<0.001);而正常对照组、HT组和轻度OSA合并HT组之间I等位基因频率分布没有显著性差别;(2) 在一个典型OSA家系中I等位基因呈高频率出现.结论:ACE基因I等位基因与中重度OSA显著相关,遗传因素是影响中重度OSA合并HT发病的重要因素.     

广西地区汉族2型糖尿病血管并发症与血管紧张素转换酶Ⅰ基因多态性关系的研究

目的　探讨 2型糖尿病 (DM)及血管并发症与ACE基因插入 /缺失 (I/D)多态性的相关情况。方法　采用多聚酶链反应 (PCR)技术 ,对 12 0名广西地区汉族 2型DM组及 10 0名汉族正常对照组ACE基因I/D多态性进行检测。结果　 2型糖尿病肾病 (DN)组ACE基因D等位基因及DD基因型频率高于正常对照组 ,Ⅰ等位基因及Ⅱ基因型频率低于正常对照组 ;2型DM合并冠心病 (CHD)组ID基因型频率高于无CHD组 ,Ⅱ型基因频率低于无CHD组。 2型DM并视网膜病变 (DR)组ACE基因各等位基因及基因型频率与无DR组及正常对照组比较无统计学意义 ;2型DM并高血压组 (HP)ACE基因各等位基因及基因型频率与无HP组及正常对照组比较无统计学意义。结论　①广西地区汉族 2型DM合并DN及合并CHD与ACE基因I/D多态性有关 ;②DD基因型及D等位基因可能为 2型DM合并DN的易感基因 ,Ⅱ型及Ⅰ型等位基因可能为 2型DM合并DN的保护基因 ;ID型基因可能为 2型DM合并CHD的易感基因 ,Ⅱ型基因可能为 2型DM合并CHD的保护基因。③广西汉族 2型DM合并HP及合并DR与ACE基因I/D多态性无关联。     

血管紧张素转化酶基因插入/缺失多态性与冠心病发病的关系

目的 :探讨血管紧张素转化酶 (ACE)基因多态性与冠心病 (CHD)发病的关系。方法 :以人基因组DNA为模板 ,应用聚合酶链式反应 (PCR)检测 5 0例CHD组和 5 6例正常对照组ACE基因第 16内含子插入 /缺失 (I/D)多态性 ,并按性别分组计算各组基因型和等位基因频率。结果 :①在CHD组中 ,ACE基因DD基因型和D等位基因频率分别为 36 %和 6 0 % ,正常对照组分别为 16 %和 4 1% ,两者相比差异有统计学意义 (P <0 .0 1)。②男性CHD组DD基因型和D等位基因频率均显著高于对照组 (均P <0 .0 5 )。女性CHD组DD基因型频率显著高于对照组 (P <0 .0 1) ,D等位基因频率与对照组比较差异无统计学意义。结论 :CHD与ACE基因I/D多态性有显著相关性 ,不论男性和女性 ,ACE基因DD基因型均可能是CHD发生发展过程中重要的危险因素之一。     

血管紧张素转换酶基因多态性与2型糖尿病并发高血压的相关性研究

目的 :研究血管紧张素转换酶 (ACE)基因多态性与 2型糖尿病并发高血压的关系。方法 :应用 PCR方法分析 149例 2型糖尿病患者及正常对照者的 ACE基因型。结果 :1ACE基因型及等位基因构成比 ,正常对照组与 2型糖尿病组无显著性差异 ;2并发高血压组 DD型及 D等位基因频率显著高于无高血压组 (P <0 .0 5 )。结论 :ACE基因 I/ D多态性与 2型糖尿病并发高血压有关。     

原发性二尖瓣脱垂综合征与血管紧张素转换酶基因I/D多态性的相关性

目的 :探讨原发性二尖瓣脱垂综合征 (MVPS)与人类血管紧张素Ⅰ转换酶 (ACE)基因I/D多态性的相关性。方法 :研究 5 0例与对照组相匹配的经超声心动图诊断为MVPS患者 ,并分为轻、重度两亚组 ,重度MVPS患者经手术、病理及电镜检查 ;用多聚酶链反应技术检测MVPS患者与ACE基因I/D多态性的相关性。结果 :重度MVPS患者手术、病理及电镜检查均证实为原发性二尖瓣黏液样变性 ,胶原、弹力纤维溶解或离断。且重度MVPS患者其I等位基因频率 (0 .6 8)明显高于对照组 (0 .5 4 ) ,P <0 .0 5 ;轻度MVPS患者其Ⅰ等位基因频率 (0 .6 0 )高于对照组 (0 .5 4 ) ,但P >0 .0 5。结论 :MVPS患者尤其是重度MVPS患者显示典型的二尖瓣黏液样变性 ,且与ACE基因I/D多态性有显著相关 ,存在有ACE基因I等位基因的异常表达。而轻度MVPS患者与ACE基因I/D多态性无显著相关 ,建议长期随访     

血管紧张素转换酶基因多态性与非杓型高血压的关系

目的研究血管紧张素转换酶 ( ACE)基因插入 /缺失 ( I/ D)多态性与非杓型高血压 ( EH)的关系。方法　 1应用聚合酶链反应 ( PCR)方法扩增 5 0例正常人、99例高血压患者的 ACE基因上 2 87bp片段 ,根据插入 ( I)或 /缺失( D)来判断其多态性。 2高血压患者行 2 4h动态血压监测 ( ABPM) ,根据 ABPM结果分为杓型 EH组和非杓型 EH组。结果　 1非杓型组与健康对照组相比 ,其 D等位基因及 DD基因型显著升高。 2非杓型组与杓型组相比 ,其 D等位基因及 DD基因型显著升高。3杓型组与健康对照组相比 ,ACE基因型和等位基因频率无显著性差异。结论　ACE基因多态性与非杓型高血压有关联性 ,DD基因型提示可能与高血压昼夜节律改变有关     

高血压合并脑梗死患者ACE基因I/D多态性分析

目的 探讨血管紧张素转换酶(ACE)基因插入／缺失(I／D)多态性与高血压合并脑梗死的关系。方法应用聚合酶链反应(PCR)方法检测54名正常人、40例高血压但无心脑血管合并症患和54例高血压合并脑梗死患的ACE基因型，同时检测血清ACE水平：结果 ACE基因I／D多态性与高血压无相关关系。与偶测血压、体重指数、血脂及载脂蛋白等临床、生化指标亦无相关关系，而与血清ACE活性显相关。高血压合并脑梗死组的ACED等位基因频率(66．7％)显高于高血压组(52．5％)和对照组(49．1％)：有高血压家族史的高血压合并脑梗死患的DD基因型频率(50．0％)及D等位基因频率(70．0％)显高于高血压组(23．1％，48．1％)和正常对照组(28．6％，51．2％)。结论 (1)ACED等位基因频率为高血压合并脑梗死的独立危险因素；(2)ACE基因缺失多态性与血清ACE活性有关，并增加高血压合并脑梗死的危险；(3)ACE基因缺失型可能为高血压合并脑梗死的遗传因素。     

血管紧张素转换酶基因缺失多态性与冠状动脉病变

目的 :探讨血管紧张素转换酶 ( ACE)基因的插入 /缺失 ( insertion/deletion,I/D)多态性与冠状动脉病变的相关性。方法 :应用聚合酶链反应 ( PCR)扩增技术检测 86例行冠状动脉造影患者的 ACE基因 I/D多态性。结果 :冠状动脉异常组的 DD基因型频率 0 .41,D等位基因频率 0 .5 2 ,显著高于冠状动脉正常组的 0 .15和 0 .2 9( P <0 .0 5 ) ;DD基因型与冠状动脉病变有关 ( OR=3.97,P<0 .0 5 )。多支病变与 DD基因型的关系更为密切 ( OR=4.72 ,P<0 .0 5 )。冠状动脉正常组、单支病变组和多支病变组的 DD型频率依次为 0 .15、0 .33和 0 .46( P <0 .0 5 ) ,D等位基因频率为 0 .2 9、0 .44和 0 .5 6( P <0 .0 1)。结论 :ACE基因的 I/D多态性与冠状动脉病变及其严重程度相关 ,DD型及 D等位基因频率随冠状动脉病变及其程度的加重而逐渐升高。在冠状动脉病变患者中 DD及 ID型患者的吸烟率、甘油三酯及血压显著低于 型者 ( P <0 .0 5 ) ,说明 D等位基因及 DD基因型可能是冠心病低危人群冠状动脉病变的重要危险因素之一。     

胆固醇酯转运蛋白基因6个多态位点与冠心病的关系

目的:了解胆固醇酯转运蛋白(CETP)基因TaqIB等6种突变的多态性与海南汉族冠心病(CHD)的关系.方法:应用针对CETP基因TaqIB、I405V、D442G、R451Q、A373P和I14A多态位点设计的等位基因特异性PCR技术,对301例海南汉族正常对照组、334例海南汉族CHD患者中CETP基因多态位点进行了检测,统计各基因型频率,计算各等位基因频率.结果:①正常对照组和CHD组中,TaqIB多态位点均可检测出B_1B_1、B_1B_2、B_2B_2 3种基因型.正常对照组B_1B_1、B_1B_2、B_2B_2 3种基因型的频率分布为45.18%、39.87%、14.95%,B_1和B_2的等位基因频率分布为65.12%、34.88%;CHD组B_1B_1、B_1B_2、B_2B_2 3种基因型的频率分布为51.50%、31.74%、16.77%,B_1和B_2的等位基因频率分布为67.37%、32.63%.②I405V突变位点可检测出Ⅱ、Ⅳ、VV 3种基因型.正常对照组Ⅱ、Ⅳ、VV 3种基因型的频率分布为15.95%、48.50%、35.55%,Ⅰ和Ⅴ的等位基因频率分布为40.20%、59.80%; CHD组Ⅱ、Ⅳ、VV 3种基因型的频率分布为15.27%、35.33%、49.40%,Ⅰ和Ⅴ的等位基因频率分布为32.93%、67.07%.③D442G突变位点可检测出DD、DG 2种基因型.正常对照组DD、DG 2种基因型的频率分布为95.35%、4.65%,D和G的等位基因频率分布为97.67%、2.33%;CHD组DD、DG 2种基因型的频率分布为63.47%、36.53%,D和G的等位基因频率分布为81.74%、18.26%.④正常对照组和CHD组中均未检测到R451Q、A373P和I14A 3种突变类型.⑤正常对照组与CHD组I405V和D442G 2个多态位点的基因型分布和等位基因频率的比较差异有统计学意义,其余多态位点在正常对照组与CHD组之间差异均无统计学意义.结论:I405V和D442G的多态性与海南汉族CHD显著相关.I405V多态位点V等位基因、D442G多态位点G等位基因是海南汉族CHD的易感基因,而I405V多态位点I等位基因对其有保护作用.D442G多态位点DG基因型可使海南汉族人群CHD的发病危险性显著增加.     

ACE I/D基因多态性与武汉地区原发性高血压代谢综合征关系的探讨

目的:探讨武汉地区原发性高血压(EH)代谢综合征(MS)与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性的关系.方法:701例武汉地区汉族人群分为3组,其中血压正常对照组303人,EH患者398例,其中EH患者中符合代谢综合征者189例,不伴随代谢综合组209例.应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法测定3组人群中ACE I/D基因多态性.结果:①ACE各基因型频率在正常对照组与EH(包括MS与非MS组)组间差异无统计学意义;②ACE Ⅱ基因型EH合并MS患者的胆固醇水平明显高于DD基因型.结论:ACE基因多态性与武汉地区原发性高血压无关,但D等位基因频率明显低于某些西方国家人群;对于EH合并代谢综合征的患者,其胆固醇水平和ACE Ⅱ基因型明显相关.     

Angiotensin-converting enzyme gene insertion/deletion (I/D) polymorphism in hypertensive patients with different degrees of obstructive sleep apnea.

To investigate the role of the angiotensin-converting enzyme gene (ACE) insertion (I)/deletion (D) polymorphism in hypertensive patients with different degrees of obstructive sleep apnea (OSA). A case-control study was performed. One hundred seventy four Chinese subjects were divided into four groups depending on the severity of OSA as follows: 1) normal control group (NC, n=68), 2) isolated hypertension group (HT, n=45), 3) hypertensive patients with mild OSA group (MO, n=27), and 4) hypertensive patients with moderate to severe OSA group (MSO, n=34). The distribution of ACE gene I/D allele and genotypes were analyzed in the subject population, as was an OSA pedigree. The study showed that the frequency of ACE gene I/D polymorphism differed significantly among the four groups. The frequency of I allele and II genotype were significantly higher in the MSO group than in the other groups (p<0.05). The distribution of I allele and II genotype showed no significant difference between any of the other groups (p>0.05, respectively). Meanwhile the higher frequency of I allele and II genotype was observed in the OSA pedigree. The higher frequency of ACE gene I allele and II genotype were closely associated with the hypertensive patients with MSO. The inherited factors played an important role in the pathogenesis of hypertensive patients with MSO.     

Plasminogen activator inhibitor-1 (PAI-1) 4G/5G and angiotensin converting enzyme (ACE) I/D gene polymorphisms and fibrinolytic activity in patients with essential hypertension and dyslipidemia

Essential arterial hypertension often predisposes patients to prothrombotic state and increased risk of vascular and organ complications. Vital role in regulation of hemostatic processes is played by genetic factors, renin-angiotensin system and disorders of lipid metabolism. Prime genetic factors involved in the process are 4G/5G polymorphism of promoter region coding tissue plasminogen activator inhibitor-1 (PAI-1) and I/D polymorphism for angiotensin converting enzyme (ACE) gene. The aim of work was the evaluation of alterations within fibrinolysis system (estimation of t-PA and PAI-1 levels), fibrinogen concentration (Fb) and ACE activity with regard to co-existent dyslipidemia and features of left ventricle hypertrophy (LVH). Moreover the analysis of influence of 4G/5G PAI and I/D ACE gene polymorphism on intensification of aforementioned alterations among hypertensive patients was performed. Research was carried out in 170 subjects under 40 years old, in two study groups, HT-- hypertensive group--125 patients with previously untreated hypertension without clinical features of ischaemic heart disease and NT--45 normotensive, healthy subjects. HT group has been further divided into four subgroups: DLP (dyslipidemic, n = 51), NLP (normolipidemic n = 74), LVH+ (with features of left ventricle hypertrophy, n = 35), LVH (-) (without features of left ventricle hypertrophy, n = 90). In a whole HT group significantly higher levels of PAI-1, t-PA and Fb were noted in comparison to NT group, considerably more pronounced within DLP rather than NLP subgroups. Moreover, pronounced increase in ACE activity was recorded in DLP and LVH+ subgroups. It has been proved that 4G/4G homozygous subjects of 4G/5G PAI-1 gene polymorphism from HT group tend to present higher levels of PAI-1 and t-PA if contrasted to 4G/4G genotype of NT group, with more distinct effect within DLP subgroup. Carriers of D allele (genotypes I/D, D/D) of I/D ACE gene polymorphism from HT group characterise with significantly higher activity of ACE in contrast to I/I genotype of HT group, with particularly marked effect in DLP and LVH+ subgroups. Basing on above mentioned results it may be concluded that essential hypertension (especially if complicated with dyslipidemia) impairs fibrinolysis, what might be related to renin-angiotensin system activation in lipid metabolism disorders. Deletion alleles of 4G/5G polymorphism (4G allele) and I/D polymorphism (D allele) in patients with hypertension independently modify fibrinolysis towards prothrombotic state with more distinct effect in dyslipidemia. Increased activity of ACE in D allele carriers may predispose to left ventricle hypertrophy.     

The association of angiotensin-converting enzyme gene insertion/deletion polymorphisms with OSA: a meta-analysis

Obstructive sleep apnoea (OSA) is an independent risk factor for hypertension. Increased angiotensin-converting enzyme (ACE) activity may be a possible promoting mechanism with different ACE insertion/deletion (I/D) genotypes influencing this activity. Studies investigating the association of ACE I/D polymorphisms with OSA have shown conflicting results. We aimed to undertake a meta-analysis of existing studies exploring the association of ACE I/D polymorphisms with the risk of OSA and hypertension. 10 studies were included in a random effects meta-analysis, comprising 1,227 OSA subjects and 1,227 controls. The effect size was measured using the odds ratio. The risk of having OSA in carriers of the D allele was 0.92 (95% CI 0.69-1.23). There was statistically significant heterogeneity across the studies (I(2)=42%, p=0.08 and I(2)=74%, p<0.0001 for genotype and allele frequency, respectively). The association of D allele frequency with the risk of OSA remained nonsignificant after stratification based on ethnicity, source of population sample, and the presence of hypertension. Subgroup analysis failed to show any influence of genotype and allele frequency on OSA severity. This meta-analysis revealed no association between the ACE I/D polymorphisms and OSA susceptibility.     

老年高血压患者血管紧张素转换酶和醛固酮合酶基因多态性与肾素血管紧张素醛固酮的关系

目的分析老年高血压晨峰患者血管紧张素转换酶(ACE)基因I/D、醛固酮合酶(CYP11B2)基因-344C/T多态性与肾素-血管紧张素-醛固酮系统(RAAS)的相关性。方法选择2016年2月~2017年12月云南省第一人民医院老年病科门诊及住院的老年原发性高血压患者200例,根据清晨血压水平分为晨峰增高组58例和非晨峰增高组142例。分析2组患者ACE基因I/D、CYP11B2基因-344C/T多态性和血浆RAAS参数的差异。结果 2组ACE基因型和等位基因频率比较,差异有统计学意义(χ^2=38.020,P=0.000;χ^2=42.040,P=0.000)。2组CYP11B2基因型和等位基因频率比较,差异无统计学意义(χ^2=0.261,P=0.878;χ^2=0.198,P=0.656)。晨峰增高组DD+TC、DD+TT基因型比例明显高于非晨峰增高组,差异有统计学意义(22.4%vs 3.5%,12.1%vs 2.1%,P<0.01);晨峰增高组II+TT、II+TC基因型比例明显低于非晨峰增高组,差异有统计学意义(13.8%vs 29.6%,P<0.05;5.2%vs 22.5%,P<0.01)。晨峰增高组血浆肾素、血管紧张素Ⅱ和醛固酮水平明显高于非晨峰增高组,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,DD+CC、DD+TC、DD+TT、肾素、血管紧张素Ⅱ为血压晨峰的重要影响因素(OR=8.084,95%CI:1.261~51.832,P=0.027;OR=14.459,95%CI:3.804~54.964,P=0.000;OR=9.753,95%CI:2.255~42.181,P=0.002;OR=1.816,95%CI:1.258~2.620,P=0.001;OR=0.634,95%CI:0.437~0.921,P=0.017)。结论 ACE基因DD型、肾素、血管紧张素Ⅱ是血压晨峰形成的主要影响因素。     

血管紧张素转化酶基因多态性对血清血管紧张素转化酶水平及血脂的影响

为探讨血管紧张素转化酶基因多态性对本地人群高血压患者和正常人血清血管紧张素转化酶及血脂水平的影响,采用聚合酶链反应技术,对118例高血压患者和98例正常人的血管紧张素转化酶基因插入/缺失多态性进行分型,并检测血清血管祭张素转化酶活性及血脂含量。结果发现,高血压组血管紧张素转化酶三种基因型(缺失纯合子型、插入纯合子型和杂合子型)及插入/缺失等位基因的频率与正常对照组比较差异无统计学意义(X2=0.468,P=0.791;X2=0.379,P=0.538)。血清血管紧张素转化酶活性在三种基因型之间差异有显著性意义(F=17.107,P=0.000)。高血压组总胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)高于正常对照组(P<0.05);高血压组三种基因型之间血脂各指标含量及正常对照组三种基因型之间总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和载脂蛋白B含量差异有显著性意义(P<0.05)。此结果提示,血管紧张素转化酶基因多态性与血清血管肾张素转化酶活性及血脂含量有关,缺失纯合子型高血压患者血清血管紧张素转化酶活性最高且易患高脂血症。     

The D allele of the angiotensin-converting enzyme insertion/ deletion (I/D) polymorphism is a risk factor for type 2 diabetes in a population-based Japanese sample

The association of the ACE gene I/D polymorphism with type 2 diabetes (DM) was examined in a population-based Japanese sample. A total of 902 individuals (490 females and 412 males, age 58.8 +/- 12.2 yr) from a cohort population (n = 3,706) of the Funagata diabetes study were divided into three groups according to genotype: D/D (n = 104), I/D (n = 436) and I/I (n = 362). Chi-square test and ANOVA were used for association studies and to assess the differences in the traits' values, respectively. More individuals with the genotypes D/D and I/D were diabetic (8.7% and 4.1%, respectively) than those with the genotype I/I (2.8%, p = 0.008 and p = 0.032, respectively). The genotype D/D was a risk factor for DM (relative risk (RR) 3.13, 95% CI 1.31-7.51), and also for DM and IGT (RR 1.78, 95% CI 14-2.76). Multiple logistic regression analysis also showed that the genotypes with the D allele were risk factors for DM and IGT even when adjusting for age, sex, hypertension and serum total cholesterol levels (odds ratio 1.49, 95% CI 1.01-2.21). The D allele of the ACE gene I/D polymorphism is a risk factor for DM.     

Relation between the angiotensin-converting enzyme insertion/deletion polymorphism and blood pressure in Japanese male subjects

Inconsistent results have been reported regarding the association of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and hypertension. Recent studies of population-based samples of three different areas in Japan presented conflicting results regarding this association. We, thus, investigated the relation between the ACE I/D polymorphism and blood pressure (BP), or the frequency of hypertension, respectively, in 706 Japanese male subjects who participated in the health check-up programme of our hospital. The ACE I/D polymorphism was determined by the polymerase chain reaction technique. Of 706 subjects, 203 were found to have hypertension and the other 503 were found to be normotensive. In all subjects, the frequencies of the DD, ID, and II genotypes were 0.123, 0.432, and 0.445, respectively, and the allelic frequency of the D allele was 0.339. In the younger subjects aged <50 years (n=264), neither systolic nor diastolic BP differed significantly among the genotypes. Conversely, in the older subjects aged > or =50 years (n=442), the systolic BP was significantly higher by 5.9 mmHg in the subjects with the ID genotype than those with the II genotype (P<0.01), and the diastolic BP was significantly higher in the subjects with the DD and ID genotypes by 5.1 and 3.3 mmHg, respectively than those with the II genotype (P<0.05 for each), although age, BMI, percentage of smoking habits, drinking habits, or the use of antihypertensive drugs did not differ significantly among the genotypes. In addition, in the older subjects, the hypertensive subjects showed significantly higher frequencies of the DD and ID genotypes and the D allele than the normotensive subjects. These results demonstrated that there was no significant association of the ACE I/D polymorphism with BP or a prevalence of hypertension in younger Japanese men aged <50 years but there was in older Japanese men aged > or =50 years.     

Angiotensin-converting enzyme gene polymorphism in north Indian population with obstructive sleep apnea

Background

A deletion of 287-bp Alu repeat of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene is associated with hypertension.

Purpose

The aim of this study is to determine the frequency of ACE (I/D) polymorphism in patients with obstructive sleep apnea (OSA).

Methods

Genotyping of ACE (I/D) gene polymorphism and estimation of serum angiotensin-converting enzyme (SACE) activity were done in 813 subjects who underwent polysomnography. Of these, 395 were apneics and 418 were non-apneics.

Results

The frequencies of II genotype (OR = 1.8, 95 % CI 1.26–2.60, p?=?0.001) and I allele (OR = 1.4, 95 % CI 1.13–1.69, p?=?0.001) of ACE gene were found to be significantly increased in patients with OSA as compared to patients without OSA. Frequency of II genotype was significantly decreased (OR = 0.46, 95 % CI 0.28–0.77, p?=?0.003) in OSA patients with hypertension. In contrast, the frequencies of ID (OR?=?1.80, 95 % CI 1.08–2.99, p?=?0.024) and DD genotypes (OR?=?2.15, 95 % CI 1.30–3.57, p?=?0.003) were significantly increased in this group. The activity of SACE was significantly decreased in the apneic group as compared to the non-apneic group (OR?=?0.99, 95 % CI 0.98–1.00, p?=?0.04).

Conclusions

The findings suggest that II genotype confers susceptibility towards development of OSA whereas DD genotype confers susceptibility towards hypertension irrespective of OSA.     

Interaction between the angiotensin-converting enzyme gene insertion/deletion polymorphism and obstructive sleep apnoea as a mechanism for hypertension

OBJECTIVE: Obstructive sleep apnoea (OSA) confers a risk of hypertension and cardiovascular complications. Both the renin-angiotensin-aldosterone system and OSA are important determinants of blood pressure, but it is not fully known how they interact. The aim of this study was to explore the interaction between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and OSA in the association with hypertension. DESIGN: A community-based, case-control design with hypertensive patients in primary care (n = 157) and normotensive population controls (n = 181). METHODS: All subjects underwent ambulatory polysomnography during one night. OSA was defined by a minimum of 10 apnoea/hypopnoea events per hour. Office blood pressure was measured and hypertension status was assessed. The genotypes were determined using polymerase chain reaction. RESULTS: An interaction analysis including sex, ACE I/D polymorphism (DD and ID versus II), and OSA identified a significant interaction between OSA and the ACE I/D polymorphism: odds ratio (OR) 6.3, 95% confidence interval (CI) 1.8-22.5, P = 0.004 as well as between OSA and sex: OR 3.3, 95% CI 1.1-9.6, P = 0.033. OSA was significantly associated with hypertension in men but not in women. CONCLUSION: The interaction between the ACE gene I/D polymorphism and OSA appears to be an important mechanism in the development of hypertension, particularly in men.     

The impact of the angiotensin-converting enzyme insertion/deletion polymorphism on severe hypoglycemia in Type 2 diabetes

The insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme gene (ACE) is associated with altered serum ACE activity. Raised ACE levels and the ACE DD genotype are associated with a 3.2 to 6.8-fold increased risk of severe hypoglycemia in type 1 diabetes. This relationship has not been assessed in type 2 diabetes. We aimed to test for association of the ACE I/D polymorphism with severe hypoglycemia in type 2 diabetes. Patients with type 2 diabetes (n = 308), treated with insulin (n = 124) or sulphonylureas (n = 184), were classified according to whether or not they had previously experienced severe hypoglycemia. Samples of DNA were genotyped for the ACE I/D polymorphism using two alternative polymerase chain reactions to prevent mistyping due to preferential amplification of the D allele. Overall, 12% of patients had previously experienced one or more episodes of severe hypoglycemia. This proportion did not differ between genotype groups (odds ratio (95% confidence limits) for carriers of D allele relative to II homozygotes: 0.79 (0.35-1.78)). This study found no evidence for association of the ACE I/D polymorphism with severe hypoglycemia frequency in patients with type 2 diabetes. However, we cannot rule out a smaller effect (odds ratio 相似文献