Non-dipping and arterial hypertension depend on clinical factors rather than on genetic variability of ACE and RGS2 genes in patients with type 1 diabetes

• Published in: Acta diabetologica 2014-08, Vol.51 (4), p.633-640
• Main Authors: Deja, G., Borowiec, M., Fendler, W., Pietrzak, I., Szadkowska, A., Machnica, L., Polanska, J., Mlynarski, W., Jarosz-Chobot, P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Blood Pressure; Child; Clinical trials; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - enzymology; Diabetes Mellitus, Type 1 - genetics; Diabetes Mellitus, Type 1 - metabolism; Female; Genetic Variation; Genetics; Humans; Hypertension; Hypertension - enzymology; Hypertension - etiology; Hypertension - genetics; Hypertension - physiopathology; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Original; Original Article; Patients; Peptidyl-Dipeptidase A - genetics; Peptidyl-Dipeptidase A - metabolism; Polymorphism, Single Nucleotide; RGS Proteins - genetics; RGS Proteins - metabolism; Young Adult
• ISSN: 0940-5429; 1432-5233
• DOI: 10.1007/s00592-014-0568-0

The aim of our study was to characterize the association of clinical and genetic risk factors such as: ACE genotype (rs17997552, rs1800764, rs4459609) and RGS2 (rs2746071) with the development of hypertension (HT) and non-dipping phenomenon in patients with type 1 diabetes mellitus (T1DM). A total of 238 adolescents and young adults with T1DM—103 females and 135 males, aged 8–30 years (mean 17.35 ± 5.2) with diabetes duration 1–26 years (mean 7.72 ± 6.2), with mean HbA1c (IFCC) 58 ± 15 mmol/mmol—were subjected to 24-h ambulatory blood pressure measurements (ABPM). The results of the ABPM were analyzed in association with the polymorphisms of ACE and RGS2 genes and clinical data of patients. HT was recognized in 65 (27 %) and non-dipping in 111 (46.63 %) patients. In the multivariate analysis of factors predisposing to HT, the variables that remained significant were the following: male sex (OR 1.62; 95 % CI 1.171–2.250), non-dipping (OR 1.40; 95 % CI 1.03–1.90) and total cholesterol level (OR 1.01; 95 % CI 1.005–1.021). The only factor influencing non-dipping was the duration of diabetes—OR 1.09 (95 % CI 1.04–1.14). The patients displaying non-dipping have a twice increased risk of development of HT (OR 2.17; 95 % CI 1.21–3.89). There was no association between disturbances of blood pressure (BP) and genotypes of ACE : rs17997552, rs1800764, rs4459609 and RGS2 : rs2746071. Clinical rather than genetic risk factors seem to be connected with BP disturbances in young patients with T1DM. Although we have identified representative groups of HT versus non-HT and dipping versus non-dipping subjects, the effect of genetic predisposition to the development of higher BP is too weak to be statistically significant.