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International Angiology 2000 December;19(4):337-44


lingua: Inglese

Angiotensin-converting enzyme gene insertion/deletion polymorphism and carotid artery wall thickness in patients with peripheral arterial occlusive disease

Taute B. M., Seifert H., Taute R. *, Gläser C. **, Podhaisky H.

From the Department of Internal Medicine/Angiology, * Institute of Medical Microbiology and ** Institute of Human Genetics and Medical Biology, Martin-Luther-University of Halle-Wittenberg, Germany


Background. It has been sug­gest­ed that the dele­tion poly­mor­phism of the angio­ten­sin con­vert­ing ­enzyme (ACE) gene is ­linked to a high risk of car­di­o­vas­cu­lar dis­ease. The rela­tion­ship ­between the inser­tion/dele­tion (I/D) poly­mor­phism of the ACE gene and the carot­id inti­ma-media thick­ness in ­patients with periph­er­al arte­ri­al occlu­sive dis­ease is ­unknown. We test­ed the hypoth­e­sis that the early pro­gres­sion of ath­ero­scler­o­sis in the extra­cra­ni­al carot­id arter­ies in ­patients with periph­er­al arte­ri­al dis­ease is asso­ciat­ed with a genet­ic pre­dis­po­si­tion.
Methods. This pros­pec­tive trial includ­ed 98 ­patients who only had man­i­fes­ta­tions of arte­rio­scle­rot­ic dis­ease in periph­er­al arte­ri­al vas­cu­lar ­regions of the lower extrem­ities (­stable stage II PAOD). Maximal com­mon carot­id inti­ma-media thick­ness (mIMT) was meas­ured using high res­o­lu­tion B-mode ultra­so­nog­ra­phy. Determinations of ACE gene poly­mor­phism were made using a poly­me­rase chain reac­tion tech­nique. Multivariate regres­sion anal­y­sis was per­formed to ­assess the influ­ence of ACE gen­o­types, ACE activ­ity and vas­cu­lar risk fac­tors on inti­ma-media thick­ness.
Results. There was no sig­nif­i­cant asso­ci­a­tion ­between inti­ma-media thick­ness and ACE gene poly­mor­phism. History of symp­to­mat­ic periph­er­al arte­ri­al dis­ease with­out local or system­ic pro­gres­sion ­exists in sub­jects with the II-gen­o­type sig­nif­i­cant­ly long­er than in sub­jects with the DD gen­o­type (p=0.01). With the pres­ence of an II-gen­o­type, there was also a ten­den­cy ­towards a thin­ner inti­ma-media thick­ness. We found sig­nif­i­cant cor­re­la­tions ­between inti­ma-media thick­ness and age (p<0.0001), fast­ing serum insu­lin (p=0.001), and lip­o­pro­tein (a) (p=0.008).
Conclusions. In the ­present study involv­ing ­patients with stage II periph­er­al arte­ri­al occlu­sive dis­ease, ACE gene poly­mor­phism could not be iden­ti­fied as a deter­min­ing mark­er for the devel­op­ment of inti­ma-media thick­en­ing in the com­mon carot­id ­artery. However, it can be ­assumed that there is a ­reduced risk for the system­ic pro­gres­sion of ath­ero­scler­o­sis in ­patients with the II gen­o­type.

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