ACE Gene Polymorphism in Turkish Children with Nephrotic Syndrome

Abstract

Since 1990, the role of angiotensin converting enzyme (ACE) gene polymorphism in various renal and cardiac diseases is still debated. This study comprised 71 pediatric patients with nephrotic syndrome, 47 males (66%) and 24 females (34%) with a mean age of 57.4 +/- 37.6 months, and a control group of 83 healthy males (59%) and 57 healthy females (41%) with a mean age of 505 +/- 160.5 months. The distribution of the ACE genotype in the control group was II, 11%; ID, 53%; and DD, 36%, and the nephrotic syndrome was II, 4%; ID, 78%; and DD, 18%. Angiotensin-converting enzyme genotypes were significantly different between patients and control groups (p<0.05). The study groups consisted of 52 (73%) with steroid-sensitive nephrotic syndrome (SNSS) and 19 (27%) with steroid-resistant nephrotic syndrome (SRNS). The distribution of the ACE genotype was II, 6%; ID, 75%; and DD, 19% in the SSNS population and ID, 84% and DD, 16% in the SRNS population. No statistically significant difference was found between steroid sensitivity and ACE genotypes (p=0.5). The results show that ACE I/D polymorphism does not contribute to the steroid resistance, even though this study indicates that the presence of the I/D genotype has a much higher risk--approximately 2.8 times--of having nephrotic syndrome. Further studies with a larger number of patients are needed.

ACE I/D Gene Polymorphism Can't Predict the Steroid Responsiveness in Asian Children with Idiopathic Nephrotic Syndrome: A Meta-Analysis

“…However, two investigations [6] [25] were performed in Caucasians and Africans respectively, which were excluded from our meta-analysis. Finally, five studies [4], [8], [26], [27], [28] were recruited into our investigation for the relationship between ACE I/D gene polymorphism and SRNS susceptibility (Table 1). Interestingly, all the recruited investigations were performed in children and those studies were published in English.…”

“…Furthermore, one report [6] was conducted in Caucasians and two [25], [30] were in Africans, and these were excluded from our investigation for the relationship between ACE I/D gene polymorphism and SSNS risk. Seven studies [4], [8], [14], [26], [27], [28], [31] were identified for the analysis of the association between ACE I/D gene polymorphism and SSNS susceptibility in our final review (Table 2). Interestingly, all the included studies were performed in children.…”

“…Five studies [4], [8], [26], [27], [28] were included in our investigation to explore whether the ACE I/D gene distributions in SRNS were different from those in SSNS (Table 3). Those five investigations contained 126 patients with SRNS and 291 SSNS children.…”

Angiotensin-Converting Enzyme Genotype Is Not a Significant Genetic Risk Factor for Idiopathic Nephrotic Syndrome in Croatian Children

“…The contribution of ACE gene polymorphism to the incidence or clinical severity of INS varies among different studies [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. DD genotype or D allele were found to be associated with the overall susceptibility to INS, as well as susceptibility to MCD and FSGS in Asian children [28,29,30].…”

“…The increased Ang II plays deleterious effects on renal hemodynamics and increases the expression of some growth factors that can take part in the onset and progression of various renal diseases [3,4,5,6,7,8]. The relationship between ACE gene I/D polymorphism and INS in children has been investigated with conflicting results [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]. The majority of investigations have been performed in Asian populations, with only scarce information from Europe and other parts of the world.…”