Angiotensin-I-Converting Enzyme (ACE) Insertion/Deletion Polymorphism in Egyptian Patients with Coronary Artery Disease

Abstract

Angiotensin-I-converting enzyme (ACE) insertion/deletion (I/D) polymorphism has been associated with the genetic susceptibility to coronary artery disease (CAD) and also with the lipid profile in different populations. One hundred and eight Egyptian patients with CAD and one hundred forty three unrelated healthy subjects were included in the study. ACE I/D polymorphism was detected by polymerase chain reaction. We investigated the association between I/D polymorphism of the ACE gene and the presence of CAD as well as its association with hypertension in the patients. Serum levels of lipoprotein (a), Lp (a), and interleukin-6 (IL-6) were estimated in the patients as well as in the healthy subjects. Increased frequency of D allele and DD genotype as well as decreased frequency of I allele and ID genotype were found in CAD patients compared to healthy subjects (P = .004, OR= 0.419, 95% CI (.2 - .8), for DD genotype), (P = .008, OR= 0.475, 95% CI (0.27-0.84), for D allele). Higher levels of both Lp (a) and IL-6 were observed in CAD patients compared to control subjects (P = .0012, P = .0346, respectively). No association was observed in ACE gene polymorphism with diabetes mellitus or hyperlipidemia. However, there is a trend for DD genotype to develop more hypertension than ID genotype (P=0.08, OR=2.88). In conclusion, theI/D polymorphism of the ACE gene (carrying the D allele) is an independent risk factor for CAD in the studied Egyptian population.