(Stroke. 2001;32:1250.)
© 2001 American Heart Association, Inc.
Original Contributions |
Low Potentiality of Angiotensin-Converting Enzyme Gene Insertion/Deletion Polymorphism as a Useful Predictive Marker for Carotid Atherogenesis in a Large General Population of a Japanese City
The Suita Study
From the Department of Preventive Cardiology, National Cardiovascular Center (T.M., S.B., N.I., J.O.), and the Department of Geriatric Medicine, Osaka University Medical School (T.K., K.I., J.H., T.O.), Suita, Osaka, Japan.
Correspondence to Toshifumi Mannami, Department of Preventive Cardiology, Fujishirodai 5-7-1, Suita, Osaka 565-8565, Japan. E-mail mtoshi{at}hsp.ncvc.go.jp
Background and Purpose—Some previous studies, almost all western, have investigated whether there is a relationship between the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) and carotid atherosclerosis. The results, however, have not been consistently positive. Further, there have been few investigations based on a large, general population. Therefore, the present study aimed to clarify whether ACE gene deletion polymorphism was associated with carotid atherosclerosis in a large Japanese general population with a more homogeneous genetic background than Caucasian populations.
Methods—Subjects aged 30 to 86 years were randomly selected from Suita City, located in Osaka, the second largest urban area of Japan, and included 1894 men and 2137 women. With the aid of high-resolution ultrasonography, carotid atherosclerosis was evaluated using our atherosclerotic indexes of intimal-medial thickness (IMT), plaque number (PN), plaque score (PS), and percentage of stenosis of the carotid artery assessed using high-resolution B-mode ultrasonography. ACE gene I/D polymorphism was detected by polymerase chain reaction.
Results—There were no
significant differences among the ACE genotypes for age and
conventional cardiovascular risk factors, except for
systolic blood pressure (SBP) and the percentage of
hypertension in men. The values of IMT, PN, and PS as carotid
atherosclerotic indexes were not significantly different among
genotypes for either sex. After adjusting for age, body mass
index, smoking habit, high-density lipoprotein cholesterol,
triglycerides, presence of hypertension, presence of
diabetes mellitus, and presence of hyperlipidemia, the
estimated ORs for the presence of IMT 
1.10 mm (defined as
thickened IMT), according to ACE genotype
(DD versus
II,
DD+ID versus
II, and
DD versus
ID+II),
for men were 0.80 (95% CI 0.60 to 1.23), 0.89 (0.62 to 1.29), and 0.89
(0.70 to 1.28), respectively. On the other hand, the ORs for women
after the same adjustment were 0.92 (95% CI 0.58 to 1.35), 0.93 (0.59
to 1.45), and 0.91 (0.59 to 1.27),
respectively.
Conclusions—Our present data suggest that ACE I/D polymorphism is not potentially a useful predictive marker for carotid atherogenesis when investigated in a large and homogeneous general Japanese population of 4031 subjects, a finding similar to that in a Caucasian population study, the Perth Carotid Ultrasound Disease Assessment Study, an Australian study based on a general population using 1111 subjects.
Key Words: angiotensins • carotid arteries • genetics • Japan • ultrasonography
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