肾素-血管紧张素系统基因多态性与2型糖尿病脑梗塞的关系

目的研究肾素-血管紧张素系统(renin-angiotensin system,RAS)中血管紧张素Ⅱ的1型受体(type1angiotensin Ⅱ receptor,AT1R)基因A1166C多态及血管紧张素Ⅰ转化酶(angiotensin1-converting enzyme,ACE)基因插入/缺失(I/D)多态与中国汉族2型糖尿病(type 2 diabetes

Association between renin-angiotensin system gene polymorphism and type 2 diabetics with stroke in China

OBJECTIVE: The aim of this study was to explore the association between gene polymorphisms of renin-angiotensin system (RAS) and type 2 diabetes mellitus (DM2) complicated with stroke. METHODS: Angiotensin 1-converting enzyme (ACE) genotypes and type 1 angiotensin II receptor(AT1R) genotypes were investigated with PCR and PCR/DdeI enzyme digesting techniques in 152 cases of DM2. RESULTS: No significant differences in genotype frequencies of AT1R gene were found between DM2 complicated with stroke and that without stroke (P> 0.05). The C allele frequency of AT1R gene in DM2 with stroke was higher than that in DM2 without stroke (6.8% vs 1.9% P< 0.05; OR=3.693, 95% CI: 0.977-13.704). The ACE DD genotype and D allele frequencies were higher in DM2 with stroke than in DM2 without stroke(51.4% vs 33.3%, P<0.05; 69.6% vs 54.5%, P<0.05). There was interaction between AT1R gene A1166C polymorphism and ACE gene I/D polymorphism in the development of stroke in DM2 patients (P<0.05; OR=4.00, 95% CI: 0.733-21.838). Logistic regression analysis showed that ACE DD genotype, systolic blood pressure and serum uric acid level were risk factors of DM2 complicated with stroke. CONCLUSION: It is suggested that ACE gene I/D polymorphism is a susceptible gene for stroke in DM2 patients in China. AT1R gene A1166C polymorphism contributes to the development of stroke in DM2 patients, but it is not an independent risk factor. There is synergistic effect of AT1R A1166C and ACE I/D gene polymorphisms on the occurrence and development of stroke in type 2 diabetics in China.