Pulmonary diffusing capacity, serum angiotensin-converting enzyme activity and the angiotensin-converting enzyme gene in Japanese non-insulin-dependent diabetes mellitus patients

• Published in: Diabetes research and clinical practice Vol. 43; no. 3; pp. 173 - 177
• Main Authors: Isotani, Haruhiko, Nakamura, Yoshio, Kameoka, Keiichi, Tanaka, Koji, Furukawa, Keizo, Kitaoka, Haruko, Ohsawa, Nakaaki
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.03.1999; Elsevier Science
• Subjects: ACE; ACE gene; Associated diseases and complications; Biological and medical sciences; Colorimetry; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Diabetic Retinopathy - physiopathology; DLCO; DNA - chemistry; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Genotype; Humans; Japan; Male; Medical sciences; Microangiopathy; Middle Aged; NIDDM; Peptidyl-Dipeptidase A - blood; Peptidyl-Dipeptidase A - genetics; Polymerase Chain Reaction; Pulmonary Diffusing Capacity; Pulmonary function disorder; Asia; Japan; ACE; DLCO; Pulmonary diffusing capacity; Pulmonary function disorder; Microangiopathy; ACE gene; NIDDM; Endocrinopathy; Retinopathy; Lung; Cardiovascular disease; Non insulin dependent diabetes; Genetic determinism; Vascular disease; Lung function; Enzymatic activity; Peptidyl-dipeptidase A; Adult; Complication; Diffusing capacity; Human; Lung disease; Pathophysiology; Respiratory disease; Enzyme; Peptidases; Eye disease; Clinical stage; Hydrolases; Peptidyl-dipeptidases; Elderly; Comparative study
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/S0168-8227(99)00006-6

We investigated the independent change in pulmonary diffusing capacity (DLCO) as one manifestation of pulmonary microangiopathy and to analyze the correlation between DLCO and serum ACE. We also examined the association between DLCO and the ACE genes. We examined pulmonary functions, especially %DLCO/VA (DLCO corrected by alveolar volume, percent predicted) in 54 NIDDM patients and 34 age-matched normal control subjects. Subjects were subdivided according to the degree of retinopathy. Serum ACE level was assayed by a colorimetric method in 54 patients and an insertion/deletion polymorphism in the ACE gene was amplified using the polymerase chain reaction in 52 of the 54 patients. There was a significant reduction of %DLCO/VA (percent predicted P<0.05) in diabetic patients. In the proliferative retinopathy (PDR) group, %DLCO/VA was significantly ( P<0.05) lower than in the no diabetic retinopathy (NDR) and simple diabetic retinopathy (SDR) groups. Although the levels of serum ACE were within normal ranges in all diabetic groups, %DLCO/VA was negatively correlated with serum ACE values ( r=0.49, P<0.0002, y=−1.4 x+109.3). Differences among DD, ID and II type of the ACE gene, with respect to the incidence of abnormal values of each clinical parameter, were not significant. DLCO was significantly reduced in patients with PDR and the serum ACE was significantly related to impaired DLCO. Our study suggests the existence of microangiopathic involvement of pulmonary vessels in NIDDM patients.