Prognostic value of the insertion/deletion polymorphism of the ACE gene in type 2 diabetic subjects: Results from the non-insulin-dependent diabetes, hypertension, microalbuminuria or proteinuria, cardiovascular events, and ramipril (DIABHYCAR), diabete de type 2, nephropathie et genetique (DIAB2NEPHROGENE), and survie, diabete de type 2 et genetique (SURDIAGENE) studies

Samy Hadjadj, Frédéric Fumeron, Ronan Roussel, Pierre Jean Saulnier, Pharmd Yves Gallois, Amos Ankotche, Florence Travert, Charbel Abi Khalil, Aurélie Miot, Francois Alhenc-Gelas, Michel Lievre, Michel Marre

Research output: Contribution to journalArticle

46 Citations (Scopus)


OBJECTIVE - We tested whether determination of the ACE insertion/deletion polymorphism is useful for renal and cardiovascular prognoses of type 2 diabetic subjects. RESEARCH DESIGN AND METHODS - The French participants (3,126 of 4,912) in the Non-Insulin-Dependent Diabetes, Hypertension, Microalbuminuria or Proteinuria, Cardiovascular Events, and Ramipril (DIABHYCAR) trial were studied for their prognosis over 4 years according to their ACE insertion/deletion polymorphism. We used two cohorts of French type 2 diabetic patients for replication: a 3-year follow-up study (n = 917; Survie, Diabete de type 2 et Genetique [SURDIAGENE] study) and a case-control study on diabetic nephropathy (n = 1,277;Diabete de type 2, Nephropathie et Genetique [DIAB2NEPHROGENE] study). We investigated the effect of the insertion/deletion polymorphism on the primary outcome in the DIABHYCAR trial (defined as the first of the following events to occur: cardiovascular death, nonfatal myocardial infarction, stroke, heart failure leading to hospital admission, or end-stage renal failure) and its components. RESULTS - In DIABHYCAR, the primary outcome and most of its components were not affected by the ACE insertion/deletion genotype. Only renal outcome was favored by the I allele (P = 0.03). The risk of myocardial infarction was not affected by ACE genotype, but the probability of fatal outcome increased with the number of D alleles (P < 0.03). In SURDIAGENE, the association between the ACE I allele andrenal outcome was not replicated. In DIAB2NEPHROGENE, no association was found with nephropathy.CONCLUSIONS - We were not able to demonstrate the manifest usefulness of the ACE insertion/deletion polymorphism for the prognosis of type 2 diabetic subjects.

Original languageEnglish
Pages (from-to)1847-1852
Number of pages6
JournalDiabetes Care
Issue number9
Publication statusPublished - Sep 2008
Externally publishedYes


ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

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