Relation of ACE gene polymorphism , angiotensinogen gene polymorphism and angiotensin receptor type 1 gene polymorphism with impared glucose tolerance in patient with end stage kidney failure

Aim and scope: RAAS renal hemodynamics is a system that has a role in blood pressure and fluid electrolyte balance regulation along with progression to end stage kidney failure. Angiotension II, the main mediator of this system, is thought to cause a functional impairment in insulin receptor and postreceptor signaling pathways. In this study, our aim was to show the relation of AC , AT1 R and angiotensinogen gene polymorphisms, that cause genetic susceptibility to over activation of RAAS, to glucose intolerance in patients with end stage kidney failure.Material and methods:100 dialysis and predialysis patients with end stage kidney failure were included in the study. Patients with no known diabetes were administered 75 gr OGTT. Based on fasting plasma glucose values and OGTT 2-hour glucose values, patients were grouped as normal patients and patients with glucose intolerance ( BAG,BGT ve DM ). Moreover, in all the patients that had undergone OGTT, insulin resistance was calculated by HOMA-IR method and insulin sensitivity index was calculated by ISI-S method. ACE gene, AT1 R gene and angiotensinogen gene polymorphism was detected by PCR method.58Results:The average creatine clearance of patients was calculated as 10,77 ± 2,40. Number of patients with normal glucose tolerance and glucose intolerance were found as 20 and 80, respectively. In the glucose intolerance group, number of patients with BAG, BGT and DM were found as 5, 25 and 50, respectively. The relation between genotype distribution of ACE gene, AT1 R gene and angiotensinogen gene and glucose intolerance was studied.Conclusion: We have obtained results suggesting a relation between ACE gene D allele and glucose intolerance in in patients with end stage kidney failure, Moreover; a relation has been shown between angiotensinogen gene T allele and insulin resistance.Keywords:Renal failure , glucose tolerance ,gene, polymorphism