Renal outcome and vascular morbidity in systemic lupus erythematosus (SLE): Lack of association with the angiotensin-converting enzyme gene polymorphism

• Published in: Seminars in arthritis and rheumatism 2000-10, Vol.30 (2), p.132-137
• Main Authors: Molad, Yair, Gal, Eyal, Magal, Nurit, Sulkes, Jaqueline, Mukamel, Masha, Weinberger, Abraham, Lalazari, Shadan, Shohat, Mordechai
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Angiotensin-converting enzyme gene; Biological and medical sciences; cardiovascular; Cerebrovascular Disorders - enzymology; Cerebrovascular Disorders - genetics; Cohort Studies; Diabetes Complications; Diabetes Mellitus - enzymology; Diabetes Mellitus - genetics; DNA - analysis; DNA Primers - chemistry; Female; Genotype; Heart Failure - complications; Heart Failure - enzymology; Heart Failure - genetics; Humans; Hypertension - complications; Hypertension - enzymology; Hypertension - genetics; Kidney Diseases - enzymology; Kidney Diseases - genetics; Lupus Erythematosus, Systemic - enzymology; Lupus Erythematosus, Systemic - genetics; Male; Medical sciences; Middle Aged; outcome; Peptidyl-Dipeptidase A - genetics; Peptidyl-Dipeptidase A - metabolism; Polymerase Chain Reaction; polymorphism; Polymorphism, Genetic; Prognosis; Prospective Studies; renal; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Severity of Illness Index; SLE disease activity index; stroke; Stroke - complications; Stroke - enzymology; Stroke - genetics; systemic lupus erythematosus
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1053/sarh.2000.8365

Objectives: The angiotensin-converting enzyme (ACE) gene polymorphism has been associated with worse outcome in various chronic glomerular disorders and in hypertension. Because nephritis and vascular morbidity are prominent determinants of outcome in systemic lupus erythematosus (SLE), we studied the distribution and prognostic effect the ACE genotype might have on the outcome of SLE. Methods: Fifty-six consecutive Israeli SLE patients and 48 (sex and ethnic origin matched) healthy individuals were evaluated for the ACE genotype by a polymerase chain reaction—based assay. The clinical and laboratory parameters of the patients as well as the SLE disease activity index (SLEDAI) and the presence of hypertension, diabetes mellitus, ischemic heart disease, congestive heart failure, and stroke were correlated with the ACE genotype. Results: The distribution of the ACE genotype D/D, D/I, and I/I in the lupus group was 59%, 36%, and 5%, respectively, similar to the distribution in the control group (54%, 31%, and 15%, respectively). We failed to find any significant association between the ACE genotype and disease manifestations, SLEDAI, renal function, or cardiovascular and cerebrovascular morbidity. The clinical and laboratory parameters associated with renal outcome and vascular morbidity in our cohort are described. Conclusions: No difference was found between the distribution of the ACE genotype in lupus patients and the general population in Israel. Renal function as well as cardiovascular and cerebrovascular morbidity among Israeli patients with SLE are disease-related and independent of the ACE gene polymorphism. Semin Arthritis Rheum 30:132-137. Copyright © 2000 by W.B. Saunders Company