RAS Gene Polymorphisms and Renal Responsiveness to RAS Inhibition Therapy in Type 2 Diabetic Asian Indians

Cheema, Balneek Singh; Kohli, Harbir Singh; Sharma, Rajni; Shah, Viral N.; Iyengar, Sreenivasan; Bhansali, Anil; Khullar, Madhu

doi:10.4172/2153-0645.1000114

Cited by 2 publications

(3 citation statements)

References 29 publications

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“…However, we have to be cautious in interpreting this finding because the favorable effects of the I allele were restricted to those with normoalbuminuria or microalbuminuria. Another study regarding RAAS gene polymorphisms and renal responsiveness to RAAS inhibition in type 2 diabetic Asian Indians was reported recently by Cheema et al [ 49 ] from India. They enrolled 810 north Indian type 2 diabetics treated with ACE inhibitor or ARB and were followed up for 3 years.…”

Section: Ace I/d Polymorphism and Antiproteinuric (Renoprotective)mentioning

confidence: 93%

“…In spite of the several limitations of this study, the deletion allele of the ACE I/D polymorphism showed unfavorable renal prognosis in patients with proteinuric type 2 diabetes, which can be improved by losartan treatment. Another recent study by Cheema et al [ 49 ] also reported that, in type 2 diabetics with nephropathy, ACE DD genotype and a genetic risk score of >6 were associated with better renoprotective response to ARB. They suggested that ACE I/D genotypes individually and in interaction with other RAS single nucleotide polymorphisms (angiotensinogen and angiotensin II type 1 receptor gene) modulate renoprotective efficacy of ACE inhibitor and ARB in type 2 diabetics depending on the status of proteinuria ( Table 2 ).…”

Section: Ace I/d Polymorphism and Antiproteinuric (Renoprotective)mentioning

confidence: 96%

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ACE Insertion/Deletion Polymorphism and Diabetic Nephropathy: Clinical Implications of Genetic Information

2014

Journal of Diabetes Research

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Approximately 20–40% of diabetic patients develop nephropathy which is the leading cause of ESRD in developed countries. The ACE I/D polymorphism is thought to be a marker for functional polymorphism which regulates circulating and tissue ACE activity. While the initial study found a protective effect of the II genotype on the development of nephropathy in IDDM patients, subsequent studies have addressed the role of ACE I/D polymorphism in the development and progression of diabetic nephropathy. RAAS blockers are the first line drugs for the treatment hypertension associated with diabetes and have been widely used in everyday clinical practice for the purpose of reducing proteinuria in patients with various renal diseases. However, the antiproteinuric effect of RAAS blockers is variable and the percentage of reducing proteinuria is in the range of 20–80%. The antiproteinuric effect of RAAS blockers may be related to a number of factors: the type or the dose of RAAS blockers, the duration of therapy, the level of sodium intake, and the type of patient's ACE I/D genotype. Besides the nongenetic factors, drug responses, can be influenced by ACE gene polymorphism. In this review, we discuss the relationship between ACE I/D polymorphism and diabetic nephropathy and therapeutic response of RAAS blockers.

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Section: Ace I/d Polymorphism and Antiproteinuric (Renoprotective)mentioning

confidence: 93%

Section: Ace I/d Polymorphism and Antiproteinuric (Renoprotective)mentioning

confidence: 96%

ACE Insertion/Deletion Polymorphism and Diabetic Nephropathy: Clinical Implications of Genetic Information

2014

Journal of Diabetes Research

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“…Moreover, there are unique genes associated with T2D in Indians [39][40][41]68]. Studies have also found that genetic polymorphisms in various genes are associated with a higher rate of diabetes complications in Indians [71][72][73]. Since the Indian population is genetically highly diverse, the findings from different studies should be interpreted while taking into account the geographical area and the ethnic group [74].…”

Section: Greater Insulin Resistancementioning

confidence: 92%