Elevated ACE Levels Indicate Diabetic Nephropathy Progression or Companied Retina Impaired

OBJECTIVES: Renin-angiotensin-aldosterone system plays important roles in the development of diabetic nephropathy (DN), and angiotensin converting enzyme (ACE) is the key factor in the process from angiotensin I to angiotensin II, but the variation and roles of serum ACE in DN patients are still unclear. METHODS: Forty-four type 2 diabetes mellitus (T2DM) patients, 75 DN patients, and 36 age-gender-matched healthy volunteers were recruited who attended Xiangya Hospital of Central South University in this case control study. Serum ACE levels and other indexes were tested with commercial kit. RESULTS: ACE levels in DN were significantly higher than T2DM and controls (F = 9.66, P < 0.001). Serum ACE levels significantly correlated with UmALB (r = 0.3650, P < 0.001), BUN (r = 0.3102, P < 0.001), HbA1c (r = 0.2046, P = 0.0221), ACR (r = 0.4187, P < 0.001), ALB (r = -0.1885, P = 0.0192), and eGFR (r = -0.3955, P < 0.001), and we got an equation that Y = 2.839 + 0.648X(1) + 2.001X(2) + 0.003X(3) - 6.637X(4) +0.416X(5) - 0.134X(6) (Y: ACE; X(1): BUN; X(2): HbA1C; X(3): UmALB; X(4): gender; X(5): ALB; X(6): eGFR, R(2) = 0.655). When DN patients were divided into advanced-stage and early-stage with or without DR, ACE levels would increase when early-stage DN develops into advanced-stage or companied with DR. CONCLUSION: Elevated serum ACE levels may hint DN progression or retina impaired of DN patients.