Resumen de Influencia del polimorfismo I/D del gen ECA en la progresión de la neuropatía diabética.
Pedro Alía Ramos, M.T. González, M.A. Navarro
Introduction. Nephropathy is a usual complication of diabetic patients. Over the last years, a possible relation between diabetic nephropathy and polymorphisms of several genes has been studied. One of them is the ACE (angiotensin converting enzyme) I/D polymorphism. Patients and methods. ACE genotype was determined by PCR in 300 diabetic patients with nephropathy and 53 non-diabetic controls. A follow-up of more than 2 years was available for 230 type II diabetics and 19 type I diabetics. The association between I/D polymorphism and progression of diabetic nephropathy was studied comparing creatinin concentrations in patients of each genotype at the beginning and at 2 and 5 years. To homogenize initial conditions concernig the severity of the nephropathy, 5 groups were established considering serum creatinin and proteinuria at start, and all of the comparisons were made inside each group. Results. Genotype distribution in patients with diabetic nephropathy was: DD, 30,7%; ID, 50,7%, and II, 18,7%, what significantly differs (p < 0,05) from that of controls (DD, 24,5%; ID, 54,7%; II, 20,8%). Otherwise, no differences were found among genotypes concerning progression of nephropathy, neither at 2 nor at 5 years in any of the previously established groups. Conclusion. ACE I/D polymorphism could play a role in the apparition of diabetic nephropathy but the evolution seems to depend more on a good clinical control.
