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Peripheral vascular disease in Type 2 diabetic Chinese patients: associations with metabolic indices, concomitant vascular disease and genetic factors
Author(s) -
Thomas G. N.,
Critchley J. A. J. H.,
Tomlinson B.,
Cockram C. S.,
Chan J. C. N.
Publication year - 2003
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2003.01046.x
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , vascular disease , concomitant , pathogenesis , endocrinology , metabolic syndrome , allele , disease , angiotensin converting enzyme , cardiology , gastroenterology , blood pressure , gene , genetics , biology
Aims Conventional and genetic risk factors have been reported to play a role in the pathogenesis of vascular disease, but do not explain the lower burden of cardiac and peripheral vascular disease (PVD) in Chinese compared with Caucasians. The role of renin‐angiotensin system (RAS) gene polymorphisms and conventional vascular risk factors has not been determined. Methods A total of 3097 Chinese diabetic subjects were screened for PVD, which was identified in 194 of the 2967 patients with Type 2 diabetes. Biochemical parameters and the genotype and allele frequencies of three RAS gene polymorphisms, the angiotensin‐converting enzyme (ACE) insertion/deletion, angiotensinogen (AGT) M235T and angiotensin II type 1 receptor (AT 1 R) A1166C polymorphisms were then compared between the PVD patients and 1046 age, gender and diabetes duration‐matched patients without PVD. Results PVD identified in 6.5% was associated with significantly worse glycaemic control, lipid profile and renal function. Smoking was more common, as were the other macro‐ and microvascular diseases. The prevalence of hypertension was similar between the groups, yet diastolic blood pressure was slightly lower in the PVD group. The ACE D allele was significantly more frequent in patients with PVD compared with the matched diabetic controls (38.1 vs. 29.8%, P = 0.039). No differences in the AT 1 R or AGT polymorphisms were observed. Conclusions PVD was associated with a worse metabolic profile and greater concomitant vascular disease than controls. The ACE I/D polymorphism was associated with PVD in these Type 2 diabetic patients. Diabet. Med. 20, ***–*** (2003)