血管紧张素转换酶基因多态性与2型糖尿病视网膜病变

目的：前瞻性地探讨血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性与2型糖尿病视网膜病变(DR)的关系。方法：应用PCR方法检测72名无DR的2型糖尿病患者，同时测定体重指数（BMI）、平均动脉压（MAP）、空腹血糖（FBG）、血肌酐（Scr）、糖化血红蛋白（HbA1c）；在严格控制血糖、血压的情况下随访6年，每1~2年复查一次眼底，血肌酐、BMI及HbA1c。结果：72例受试者退出7例，退出率为9.7%；ACE II，ID，DD 3种基因型在入组和终点时各临床参数（BMI，MAP，FBG，Scr，HbA1c）差异无显著性(P＞0.05)；到达终点时，各组背景型DR（II 42.9%,ID 47.8%，DD 42.9% ）、增殖型DR(II 25.0%,ID 21.7%,DD 21.4%)及DR总发生率（II 67.9%,ID 69.6%,DD 64.3%）差异无统计学意义(P＞0.05)。结论：ACE基因I/D多态性与中国汉族2型糖尿病病人DR的发生和发展无关联。

Angiotensin converting enzyme gene polymorphism and Type 2 diabetic retinopathy

OBJECTIVE: To prospectively clarify the relationship between angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and diabetic retinopathy (DR) in Type 2 diabetic patients. METHODS: A 6-year prospectively study was designed to investigate the change of retina of 72 Type 2 diabetic patients without retinopathy . All patients suffered from diabetes mellitus for more than 5 years and matched well in age, body mass index (BMI), mean arterial pressure (MAP), and fasting blood glucose (FBG). Patients were classified into 3 groups according to their genotypes of ACE. ACE gene I/D polymorphism was identified by polymerase chain reaction. The patients were followed up for 6 years and their BMI, serum creatinine (Scr), MAP, HbA1c, and retina were checked once every 1 - 2 years. RESULTS: Seven subjects (9.7%) were discontinued prematurely. At the end of the study, there were no significant differences in the clinical parameters such as BMI, MAP, FBG, HbA1c, and Scr among the 3 groups (P > 0.05), and also in DR incidence in Type 2 diabetic patients among the 3 groups (II 67.9%, ID 69.6%, DD 64.3%, respectively, P > 0. 05). CONCLUSION: There is no association between ACE gene I/D polymorphism and the genesis and development of DR in Type 2 diabetic patients.