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Hypoglycemia, S-ACE and ACE genotypes in a Danish nationwide population of children and adolescents with type 1 diabetes.
MedLine Citation:
PMID:  20546161     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: High S-ACE levels have been shown to predispose to increased risk of hypoglycemia, however; some inconsistency relates to the risk of the ACE genotype. We investigated the association between S-ACE level at diagnosis and ACE genotype to long-term risk of severe hypoglycemia in more than 1000 children and adolescents with type 1 diabetes being part of the Danish Registry of Childhood diabetes over a 10-yr period.
RESEARCH DESIGN AND METHODS: The Registry provided annual registration of clinical data, e.g., HbA1c, blood glucose monitoring, insulin type and dosage and acute diabetic complications (hypoglycemia and DKA). A BioBank coupled to the Registry comprised serum for measuring S-ACE levels and DNA for ACE genotyping.
RESULTS: A total of 1037 individuals were included, aged 9.97 yr (SD 3.84). A total of 622 severe hypoglycemic episodes were observed in 270 individuals. Associations to increased risk of hypoglycemia generated from a negative binominal model were long diabetes duration (p < 0.0001) and high S-ACE level (p = 0.0497) when adjusted for ACE genotype. In the stratified analysis, S-ACE and insulin dosage were associated with hypoglycemia in girls (p = 0.026 and 0.028, respectively). An association of S-ACE level to ACE genotype was identified; however, no difference in the frequency of hypoglycemia, diabetes duration or HbA1c was demonstrated between ACE genotypes.
CONCLUSION: This large nationwide cohort has identified an increased risk for hypoglycemia associated with higher S-ACE level, however only in girls. A strong association was found between ACE genotype and S-ACE levels, but ACE genotype was not related to risk of hypoglycemia.
Authors:
Jesper Johannesen; Jannet Svensson; Regine Bergholdt; Stefanie Eising; Hanne Gramstrup; Erik Frandsen; Jens Dick-Nielsen; Lars Hansen; Flemming Pociot; Henrik B Mortensen;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric diabetes     Volume:  12     ISSN:  1399-5448     ISO Abbreviation:  Pediatr Diabetes     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100939345     Medline TA:  Pediatr Diabetes     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  100-6     Citation Subset:  IM    
Copyright Information:
© 2010 John Wiley & Sons A/S.
Affiliation:
Department of Paediatrics, Glostrup University Hospital, DK-2600 Glostrup, Denmark. jesjoh02@glo.regionh.dk
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