ASSOCIATION OF ANGIOTENSIN CONVERTING ENZYME ACTIVITY AND GENOTYPING WITH METABOLIC SYNDROME

The aim of this work is to study the association of ACE activity and genotyping with metabolic syndrome, and to try to asses the possible role of ACE genotyping in the pathogenesis of varying components of metabolic syndrome. This study was carried out in the medical Biochemistry and Internal Medicine Departments, Faculty of Medicine, Zagazig University. Eighty subjects were included and were classified into 3 groups:Control group: Comprising 20 healthy subjects (9 males and 11 females; with a mean age of 53.5 4.8 years) not suffering from any disease interfering with our study.Type II diabetes group: Comprised 20 subjects (12 males and 8 females; with a mean age of 56.15.8 years) with type 2 diabetes and without any other component of metabolic syndrome.Metabolic group: Comprised 40 patients (17 males and 23 females; with a mean age of 54.94.6 years) with type 2 diabetes and two or more of other components of metabolic syndrome.All groups well further subclassified according to genotype (DD, ID, II)From these findings we concluded that: The ACE DD genotype is associated with type 2 diabetes as well as metabolic syndrome. 20 % of involved subjects have DD genotype and are more risky for metabolic syndrome. ACE DD genotype is associated with increased circulating ACE activity. ACE DD genotype has higher serum levels of TC, LDL-c, and TG. In addition, DD genotype has lower serum levels of HDLc and Apo A. Furthermore, D allele–containing genotypes associated with type II diabetes, dyslipidemia, hypertension, and microalbuminurea. Our results may provide genetic evidence to explain the clustering of components of metabolic syndrome, and suggest that RAS may be involved in the pathophysiology of metabolic derangement in patients with type II diabetes. ACE DD genotype and ACE activity is associated with increasing insulin resistance which participate in the pathogenesis of metabolic syndrome component. Our results suggest that the renin angiotensin system plays a role in the pathogenesis of cardiovascular and renovascular complications. Diabetic patients with DD genotypes are at increased risk for development of metabolic syndrome. So, the use of ACE inhibitor treatment in those high risk patients may decrease the incidence of cardiovascular events and overt nephropathy.Genotype I/I which abundant in obese subjects, may be reasonable for production of different ACE phenotype that responsible for ACE activity in adipose tissue. So, further investigation is required for ACE phenotype which is associated to different genotypes.