DOI: https://doi.org/10.26641/2307-0404.2013.4.20370

Gene polymorphism of endothelial NO-synthase, angiotensin-converting enzyme and receptors of angiotensin II type 1 in patients with coronary artery disease and type II diabetes.

L. M. Yakovleva

Abstract


Purpose: to study the clinical manifestations of coronary artery disease (CAD) in patients with diabetes mellitus (DM) II type and the possible association of mutations in the genes of endothelial NO-synthase (eNOS), angiotensin-converting enzyme (ACE) and receptor of angiotensin II type 1 (AT2R1) with the development of type II diabetes in these patients. Mate­rials and methods. The study involved 318 patients with CAD, of whom 54 (17,0%) patients had type II DM and 264 (83,0%) patients -without diabetes. Study of allelic polymorphism of T-786S of eNOS gene promoter, insertion-deletion (I/D) polymorphism of ACE gene and polymorphism A1166S of AT2R1 gene was performed by polymerase chain reaction. Results. In patients with CAD and DM type II such risk factors as hypertension, obesity, family history with early onset of cardiovascular disease were significantly more common; CAD manifestation occurs at a younger age, myocardial ischemia more often has silent nature. In the presence of type II DM, coronary artery lesions were of diffuse and multivessel character, other vascular pools are often involved in the atherosclerotic process. An independent as­sociation of type II diabetes with hypertension, obesity, and CC genotype of eNOS gene T-786S polymorphism was identified in patients with CAD. Negative independent influence of ACE gene I/D polymorphism of D allele and AT2R1 gene A1166S polymorphism C allele on renal function in patients with CAD and type II DM was proved.

Keywords


diabetes mellitus; coronary artery disease; gene polymorphism

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