Angiotensin converting enzyme (ACE) activity levels in insulin-independent diabetes mellitus and effect of ACE levels on diabetic patients with nephropathy

Abstract

Involvement of complications is considered to be one of the major factors in the prognosis of diabetes mellitus (DM). Recent studies indicate that most diabetic complications such as nephropathy and hypertension are vascular-originated. Renin-angiotensin involvement, especially changes in ACE activity level, is considered to be a key factor since ACE converts angiotensin I to angiotensin II which is a potent vasoconstrictor and plays a vital role in the regulation of blood pressure. Our present study focused on ACE activity levels along with blood glucose and HbA(1c) levels in diabetic patients with (n=18) or without (n=25) nephropathy as compared to control subjects (n=25). Blood glucose levels were significantly higher in both diabetic groups compared to controls (p<0.001). On the other hand, compared to controls, blood HbA(1c) levels were slightly higher in DM patients without complications whereas they were significantly increased in nephropatic DM patients (p<0.001). There was a very strong increase (p<0.001) at the level of ACE activity in both of the diabetic groups (with nephropathy: 47.11+/-3.70 U l(-1); without complications: 43.72+/-2.93 U l(-1); controls: 25.15+/-2.30 U l(-1)). ACE activity levels were also significantly higher in diabetic patients with nephropathy than in type II DM patients without complication (p<0.01). Our results demonstrate that ACE activity levels are increased in diabetic patients. Additional significant increase in ACE activity levels in diabetic patients with complications such as nephropathy supports the hypothesis that ACE activity has an essential role in the development of complications in diabetes.

Mitochondrial uncoupling proteins regulate angiotensin‐converting enzyme expression: crosstalk between cellular and endocrine metabolic regulators suggested by RNA interference and genetic studies

“…Age‐adjusted sACE was therefore used in subsequent analyses. As expected, sACE activity was higher in T1DM subjects, with levels similar to those of previously published data . The wide distribution of ACE activities in the T1DM group may partly reflect differences in diabetic phenotype, such as the presence or absence of nephropathy .…”

“…It is worthy to note that ACE activity was substantially higher in the T1DM group than in HMAR groupa finding unlikely related to the use of two different methodologies of ACE assay. Indeed, an established literature shows ACE activity (when assayed using the same commercial Sigma assay we used) to be elevated in diabetic people to levels commensurate with those we identified and with similar levels in controls to those we report [56].…”

Bioactive molecules from soybeans (Glycine max) with anti-type 2 diabetes activity: a systematic review

“…ACE is an important enzyme that plays a crucial role in the RAAS, which is involved in regulating blood pressure, fluid balance, and electrolyte homeostasis in the body. ACE is responsible for converting angiotensin I to angiotensin II, a potent vasoconstrictor that also stimulates the release of aldosterone [179]. ACE inhibitor therapy reduces both microvascular and macrovascular complications in diabetes and appears to improve insulin sensitivity and glucose metabolism [180].…”

Angiotensin II, PPAR-Gamma and atherosclerosis

“…ACE activity is significantly enhanced in both diabetic subjects and animal models of type 2 diabetes (32). AT1R expression is also significantly upregulated in the vasculature of diabetic rat models (33,34), suggesting that elevated AT1R expression could potentiate the AngII atherosclerotic activity in type 2 diabetes. Finally, at the signal transduction level, diabetesassociated hyperglycemia has been shown to induce VSMC nuclear factor (NF)-kappaB activation (35), which is known to regulate several inflammatory mechanisms involved in atherosclerosis, including AT1R signal transduction (36).…”