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Angiotensin‐Converting Enzyme (ACE): Relationship to Insulin‐dependent Diabetes and Microangiopathy
Author(s) -
Toop M. J.,
Dallinger K. J. C.,
Jennings P. E.,
Barnett A. H.
Publication year - 1986
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 - 10.1111/j.1464-5491.1986.tb00790.x
Subject(s) - microangiopathy , medicine , endocrinology , diabetes mellitus , retinopathy , angiotensin converting enzyme , diabetic retinopathy , insulin , diabetic angiopathy , albuminuria , endothelium , blood pressure
Angiotensin‐converting enzyme (ACE) is secreted by the vascular endothelium and serum activity may reflect endothelial damage. A study of 48 insulin‐dependent diabetics, 15 with and 33 without evidence of diabetic retinopathy and 41 non‐diabetic controls was performed. ACE activity was significantly elevated in the diabetics compared with controls (mean ± SD 46 ± 14 vs 35 ± 9 U/I, p <0.001) (units in micromoles substrate converted/min/l serum). This elevation was more marked in diabetics with such evidence of microangiopathy as retinopathy or raised albumin excretion rate (AER) (51 ± 14 U/I, p <0.0001), and also in those with raised AER alone (47.2 ± 15 U/I, p <0.002). Patients with both raised AER and retinopathy had significantly higher ACE activities than those with no complications (53 ± 15 vs 41.2 ± 15 U/I, p <0.05). No correlation was found with glycosylated haemoglobin or smoking habits. We conclude that mean serum angiotensin converting enzyme activity is increased in insulin‐dependent diabetes, particularly in those with evidence of microangiopathy and this may reflect microvascular damage.