The presence of allele D of angiotensin-converting enzyme polymorphism is associated with diabetic nephropathy in patients with less than 10 years duration of Type 2 diabetes

Aim To investigate the association between angiotensin‐converting enzyme gene I/D polymorphism and diabetic nephropathy (DN) in patients with Type 2 diabetes mellitus (DM) taking into consideration the known duration of DM. Methods Cross‐sectional study with 982 patients categorized according to urinary albumin excretion (UAE) into normoalbuminuria (UAE 174 mg/l or dialysis). Patients were further grouped regarding presence of the D allele (DD/ID vs. II) and DM duration (≤ 10 years or > 10 years). Results Incipient DN was diagnosed in 17.3% (n = 170), and 20.7% (n = 203) had overt DN (macroalbuminuria, n = 129; dialysis, n = 74). Genotype distribution (DD/ID/II) was similar in patients with incipient (49/92/29) or overt DN (77/89/37) if compared with patients without DN (181/308/120, P = 0.172). In patients with DM ≤ 10 years, having the D allele (DD/ID) resulted in an odds ratio (OR) of 2.66 (95% CI: 1.12–6.58, P = 0.015) for incipient DN, and 3.19 (95% CI: 1.18–9.30, P = 0.012) for overt DN. In patients with longer DM duration, the D allele did not increase the risk for incipient (OR 0.68, 95% CI 0.36–1.29, P = 0.206) or overt DN (OR 0.67, 95% CI 0.39–1.17, P = 0.138). Conclusion The DD/ID genotypes were associated with incipient or overt DN in patients with DM ≤ 10 years.