[Polymorphism I/D of the angiotensin-converting enzyme gene and disturbance of blood pressure in type 1 diabetic children and adolescents]. / Zaburzenia cisnienia tetniczego u dzieci i mlodziezy chorej na cukrzyce typu 1 a polimorfizm I/D genu enzymu konwertujacego angiotensyne.

ABSTRACT

AIM: The aim of the study was to evaluate an association between ACE genotypes and blood pressure (BP) disturbances in children and adolescents withType 1 diabetes mellitus. MATERIALS AND METHODS: 126 normo-albuminuric, type 1 diabetic children and adolescents at the age 10.5-19.7 years, and duration of diabetes 2.0-17.8 years, were included in the study. All patients were clinically normotensive and normoalbuminuric. Twenty-four-hour ambulatory BP monitoring was undertaken in all patients. The values of systolic BP, diastolic BP, mean arterial BP blood pressure and diurnal variation in BP were estimated. Prehypertension was diagnosed as BP values between 90pc or 120/80 mmHg and 95pc. ACE genotypes were assessed using polymerase chain reaction. RESULTS: In 48 individuals (38.1%) prehypertension was diagnosed. ACE genotypes distributed in patients were as follow 31 (24.6%) genotype II, 45 (35.7%)--ID, and 50 (39.7%)--DD. Patients with DD genotype had higher nocturnal systolic BP (104 vs. 101 mmHg; p=0.029), diastolic BP (54 vs. 52 mmHg, p=0.003) and mean arterial BP (71 vs. 68 mmHg, p=0.003) as compared to carriers of the I allele (group ID + II). In the group DD in compare to the group ID + II lower nocturnal depletion in diastolic BP (18.0 vs. 20.5 mmHg, p=0.024) and mean BP (14.8 vs 16.6 mmHg, p=0.049) was observed. 14% patients of the DD group were non-dipper and 1.32% in the group ID + II (p=0.01). There was no differences in the prevalence of prehypertension between genotype groups (II+ID vs. DD 38.2 vs. 38.0%, ns). CONCLUSIONS: Genotype DD is associated with nocturnal BP abnormalities in normotensive and normo-albuminuric children and adolescents with type 1 diabetes. There is no relationship between frequency of prehypertension and ACE gene polymorphism.