Relationship between renin-angiotensin gene system and endothelial NO synthase gene polymorphism and angiocomplications of type 2 diabetes mellitus

The insertion/deletion (I/D) polymorphism of angiotensin 1-converting enzyme (ACE) gene, T174M (threonine substitution for methionine in position 174 of amino acid sequence) polymorphism of angiotensinogen (AGT) gene, A1166C polymorphism of angiotensin II vascular (type 1) receptor (AT1R) gene, and ecNOS4a/4b polymorphism of endothelial N О synthase (NOS3) gene were studied by the polymerase chain reaction (PCR) in patients with type 2 diabetes mellitus and arterial hypertension uncomplicated (control, n = 52) and complicated with cardiovascular diseases (myocardial infarction, n = 53, and acute cerebrovascular disorders, n = 50). Protective effect of 1/1 genotype on development of myocardial infarction in diabetics was shown. The absence of significant differences in the distribution of alleles and genotypes of A GT gene in three groups of patients indicates that this gene is hardly involved in the formation of cardiovascular complications in type 2 diabetes. A strong association between A1166C polymorphism of AT1R gene and development of myocardial infarction in patients with type 2 diabetes and essential hypertension of the Moscow population was revealed; allele A and genotype AA attenuate the risk of early myocardial infarction, while allele C and genotype CC enhance it. A relationship between minisatellite ecNOS4a/4b polymorphism of NOS3 gene and cardiovascular diseases was detected in patients with type 2 diabetes and essential hypertension. Allele 4a and genotypes 4a/4b and 4a/4a are pronounced risk markers, and allele 4b and genotype 4b/4b carriership is associated with a low risk of this complication.

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