Association Of Angiotensin-converting Enzyme 2 Gene A/G Polymorphism And Albuminuria In Chinese Patients With Hypertension

Objiective: To investigate whether angiotensin-converting enzyme 2(ACE2) gene A/G single nucleotide polymorphism is associated with albuminuria in Chinese patients with hypertension.Research design and methods: this study was designed in a case-control manner. 204 patients with essential hypertension were randomly enrolled into this study.The criteria of hypertension was based on the 1999 WHO/ISH guidelines(SBP＞140mmHg and/or DBP＞90mmHg). Basal phenotyping included clinical history,phisical examination such as blood pressure,heart rate,laboratory tests such as fasting plasma glucose(FPG), postprandial blood glucose, plasma triglyceride(TG), total cholesterol(TC), microalbuminuria and proteinuria.Three groups were designed in our research which included hypertension without microalbuminuria, hypertension with microalbuminuria and hypertension with proteinuria.The genotypes of G8790A polymorphism in ACE2 gene of total 204 subjects were analyzed by combined polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP).Results:1.For femal patients,the frequency of genotypes in group of hypertension without microalbuminuria were GG 28.6%,GA 30.2%,AA 41.2% respectively,in group of hypertension with microalbuminuria were GG 31.6%,GA 52.7%,AA 15.7%,and in group of hyperension with proteinuria wereGG 25%,GA58.3%,AA16.7% respectively.The frequency of G allele and A allele were 43.7%,56.3% in group of hypertension without renal insufficency, 57.9%,42.1% in group of hypertension with microalbuminuria, and 54.2%, 45.8% in group of hypertension with proteinuria.The genotype frequencies were significantly different among groups (X~2=9.527,P=0.049). There was significant difference in allele frequency among three groups(P＜0.01).For males, The frequency of G allele and A allele were 39.6%,60.4% in group of hypertension without renal insufficency,64.7%,35.3% in group of hypertension with microalbuminuria,and 50%,50% in group of hypertension with proteinuria. There was not significant difference in allele frequency among three groups.2.The mean value of TC of group of hypertension with proteinuria was higher than other two groups(P=0.064).Group of hypertension with proteinuria had a higher TG level than other two groups(P=0.02), a higher postprandial blood glucose than other two groups (P=0.008),and a higher diastolic blood pressure than other two groups (P=0.012).3.There was no relationship between angiotensin-converting enzyme 2 gene A/G polymorphism and blood pressure, mean value of TC,mean value of TG, plasma glucose.4. The multivariate logistic regression analysis indicated that GA genotype were independent risk factors of renal insufficiency in patients with hypertension.Conclusion: 1.Hypertensive patients with proteinuria had higher TG, TC, postprandial blood glucose,and diastolic blood pressure than other two groups.That indicated the blood pressure,blood glucose,TG, and TC may influence proteinuria of hypertensive patients.2.The polymorphism of ACE2 gene G8790A was associated with proteinuria in hypertensive patients.That means hypertensive patients with GA gene type or carrying G allele had a high er risk of proteinuria. There was no significant relationship between angiotensin-converting enzyme 2 gene A/G polymorphism and blood pressure, mean value of TC,mean value of TG, plasma glucose.