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Study Explores Genetics of Microalbuminuria in Diabetes

Ala12 allele of Pro12Ala PPAR-γ2 polymorphism linked to less risk of new-onset microalbuminuria

TUESDAY, Dec. 8 (HealthDay News) -- In patients with type 2 diabetes and high blood pressure, the Ala12 allele of the Pro12Ala polymorphism of peroxisome proliferatoractivated receptor-γ2 (PPAR-γ2) may reduce the risk of persistent microalbuminuria, according to research published in the December issue of Diabetes.

Salvatore De Cosmo, M.D., of the Casa Sollievo della Sofferenza in San Giovanni Rotondo, Italy, and colleagues analyzed data from 1,119 patients with type 2 diabetes and hypertension who had participated in a randomized trial assessing the effect of ACE inhibition on new-onset microalbuminuria. Most patients (84.2 percent) were homozygous for the Pro12 allele of the Pro12Ala polymorphism of PPAR-γ2, thus dubbed 'Pro/Pro homozygotes,' and 0.6 and 15.2 percent were homozygous and heterozygous for the Ala12 allele, thus dubbed 'Ala carriers.'

During follow-up, the researchers found that Ala carriers had a lower risk of developing microalbuminuria than Pro/Pro homozygotes (hazard ratio, 0.45). They also had significantly lower final albuminuria (7.3 versus 10.5 µg/minute, respectively). In the Pro/Pro group, those on ACE inhibitor therapy had significantly lower risk of microalbuminuria than those on non-ACE inhibitor therapy (hazard ratio, 0.46).

"Screening for the Pro12Ala PPAR-γ2 polymorphism may help to identify patients at increased risk who may benefit the most from early ACE inhibitor therapy. Further studies are needed to unravel whether protection from microalbuminuria may translate into a reduced long-term risk of renal and cardiovascular events in this population," the authors write.

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