Angiotensin I-converting enzyme gene polymorphism in myocardial infarction in patients with type 2 diabetes

Insertion/deletion (I/D) polymorphism of angiotensin I-converting enzyme gene (ACE) as a potential marker of genetic susceptibility to myocardial infarction (MI) was studied in 76 patients with non-insulin-dependent diabetes (NIDDM) surviving after MI, 115 NIDDM patients without history of MI, and 165 subjects without diabetes from the general Moscow population. Case-control association study failed to reveal significant differences in distribution of ACE gene alleles and genotypes between patients with and without MI. However, we observed a tendency of I allele frequency to decrease and of D allele frequency to increase in infarction. Moreover, patients with MI had almost the same pattern of I and D allele and DD genotype distribution as normal subjects from general population (34.9, 65.1, and 46.1% vs. 35.8, 64.2, and 48.5%, respectively). On the other hand, diabetics without infarction had a slightly higher prevalence of I allele and I allele-containing genotypes (ID and II) than patients with documented MI (40.4, 46.1, and 17.4% vs. 34.9, 38.2, and 15.7%, respectively) and lower DD genotype frequency (36.5 vs. 46.1%), respectively). Therefore, we suppose that in Moscow a higher incidence of D allele in comparison with I allele and of its genotypes ID and II may be regarded as a genetic protective factor, whereas D allele and DD genotype as a factor of genetic susceptibility to MI in NIDDM patients.

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