Hypoglycemia, S-ACE and ACE genotypes in a Danish nationwide population of children and adolescents with type 1 diabetes
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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.
Original language | English |
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Journal | Pediatric Diabetes Online |
Volume | 12 |
Issue number | 2 |
Pages (from-to) | 100-6 |
Number of pages | 7 |
ISSN | 1399-5448 |
DOIs | |
Publication status | Published - Mar 2011 |
- Adolescent, Age of Onset, Child, Cohort Studies, Denmark, Diabetes Mellitus, Type 1, Female, Genetic Predisposition to Disease, Genetics, Population, Genotype, Humans, Hypoglycemia, Male, Peptidyl-Dipeptidase A, Registries, Journal Article, Research Support, Non-U.S. Gov't
Research areas
ID: 174686518