Renin Angiotensin Aldosterone System Gene Polymorphisms among Type 2 Diabetic Patients with Retinopathy and Nephropathy

Introduction:Diversified pathways are associated with the advancement of type 2 diabetes mellitus (T2DM) towards retinopathy and nephropathy. Experimental data have suggested the role of renin-angiotensin-aldosterone system (RAAS) gene polymorphism in diabetic nephropathy (DN) patients. Since very few combined studies were done for RAAS genes in T2DM patients with DN and diabetic retinopathy (DR), we tried to explore the association of certain RAAS gene polymorphisms in them.Methods:Single nucleotide polymorphisms (SNPs), Met235Thr of angiotensinogen (AGT) gene, and insertion/deletion (ins/del) of angiotensin-converting enzyme (ACE) gene from RAAS pathway were studied using polymerase chain reaction (PCR) method in this cross-sectional study. T2DM patients diagnosed with nephropathy and retinopathy were selected (n = 125 each) consecutively and compared with T2DM patients without DN and/or DR. SPSS software was used for statistical analysis.Results:Considerably higher blood pressure, serum urea, and creatinine levels were found among DN patients. The DD genotype of ACE SNP was significantly higher in the DR and DN groups (OR: 2.87,95%CI: 1.48-5.56, P = 0.002 and OR: 2.36,95%CI: 1.23-4.53, P = 0.010) compared to the DM Group. In AGT Met235Thr SNP, the CC and TC genotypes were significantly increased in DN while only the TC genotype was significantly increased in the DR group.Conclusion:ACE ins/del and AGT Met235Thr SNPs were significantly related to the risk of development of nephropathy and retinopathy in T2DM patients.