The Relationship Between Angiotensin Converting Enzyme And Diabetic Retinopathy

ObjectiveTo investigate the relationship between serum angiotensin converting enzyme(ACE) levels and the development and progression of diabetic retinopathy .MethodsWe adopted prospective clinical design and contrast study.Serum levels of ACE were measured in 185 diabetic patients divided into the following three groups:77 diabetic patients without DR,53 diabetic patients with nonproliferative diabetic retinopathy(NPDR),55 diabetic patients with proliferative diabetic retinopathy(PDR).Serum levels of ACE were measured in 55 healthy subjects without family history of diabetes and in 50 healthy subjects with family history of diabetes.Each subjects underwent examination of vision or corrective vision, slit-lampexamination, direct fundus examination ,diabetic patients were received fundus fluorescein angiograph(FFA) in addition.After an overnight past ,blood was taken for determination of ACE and fasting blood glucose.When the data from the above three groups of subjects were submitted to statistical tests(one-way ANOVA,T-test of Dunnett T3 and test of student-newman-keuls and linear regression analysis).Result1. The difference between the mean ages and sex of every groups was not significant(p>0.05).2. The mean levels of ACE was 80.88 ± 28.67U/L,83.25± 26.59U/L, 91.95 ± 24.71U/L Respectively, in healthy subjects without or with family history of diabetes and in NDR;The difference between the mean levels of ACE of in healthy subjects with or without family history of diabetes and in NDR was not significant (p>0.05).3. The mean levels of ACE was 112.1±33. 6U/L in diabetes patients .Levels of ACE were significantly elevated in the whole diabetic group as compared with control subjects (p<0.001).4. The mean levels of ACE was 91.95 ± 24.71U/L, 109.13 ± 19.11U/L, 143.13 ± 32. 66U/L, respectively , in NDR and in NPDR and in PDR. Levels of ACE were significantly elevated in PDR as compared with NPDR; Levels of ACE were significantly elevated in NPDR as compared with NDR. The difference between the mean levels of ACE in NDR, NPDR and PDR group was significant(p<0.001).5. Significant correlation was obtained between serum ACE activity, fasting blood glucose and duration of diabetes.Conclusions1. Serum ACE levels were elevated in type 2 diabetes with DR as compared with without DR,correlation was found between ACE levels and the development and progression of DR. we presumed Serum ACE levels and the development and progression of DR was correlation.2. The difference between the mean levels of ACE in healthy subjects with familyhistory of diabetes and in healthy subjects without family history of diabetes was not significant.we think serum ACE levels and family history of diabetes were not correlation, we presumed serum ACE levels may not hereditary susceptibility in healthy subjects with family history of diabetes.