Balkan Journal of Medical Genetics

The subjects who had the homozygous deletion (DD) genotype had the highest ACE frequency, while subjects who had the homozygous insertion (II) genotype had the lowest ACE levels. Studies from the United States, German and Finnish populations did not find a relationship between AP and I/D polymorphisms [9,20].We found the DD genotype to be more prevalent in healthy controls than in patients with AP, however, the II genotype was significantly more prevalent in AP patients than in healthy controls (p <0.05). Even so, the ACE II genotype was significantly higher in severe AP patients than in healthy controls, and ACE II was not related to the etiology of pancreatitis.

Studies in the European populations, revealed the ratio for the ACE genotype DD/ID/II to be 1:2:1. However, in Turkey, the DD genotype is the most frequent, and genotype II the least common in the healthy population [21-23]. This may be one of the reasons for the difference between our results and these from studies of the United States, German and Finish populations [9,20]. A relationship between the II genotype and inflammation and pancreatic injury needs further clarification.

It has been suggested that the DD genotype is related to essential HT and DM [23,24]. On the other hand, the association between the I/D polymorphism and HT and DM is still controversial [24-27]. A study from Turkey did not show a significant association between the ACE gene polymorphism and HT in diabetic patients [26]. A study from Sweden showed that the DD genotype increases the risk of HT in diabetic patients [28].

We did not find significant difference either in the distribution of the I/D genotype polymorphism or allele frequency in diabetic AP and hypertensive AP groups. We have found that the ACE II genotype and allele I frequencies are higher in the patients who have both diabetes and HT compared to patients who have only one of these diseases. In conclusion, the ACE gene polymorphism may play in role in AP. We need larger studies for investigating the relation of the ACE I/I genotype with other inflammatory parameters. By such studies we could evaluate the significance of the ACE I/I genotype in AP and its possible use as a genetic marker.