Association Between Angiotensin Converting Enzyme Gene Insertion\Deletion Polymorphism and Coronary Heart Disease in Gaza Strip
International Journal of Biomedical Materials Research
Volume 4, Issue 3, December 2016, Pages: 18-26
Received: Oct. 8, 2016; Accepted: Oct. 17, 2016; Published: Nov. 10, 2016
Views 3355      Downloads 148
Lamia'a Sobhi. Saqer, Medical Sciences Department, University College of Science and Technology, Gaza Strip, Palestine
Haneen Ahmad. Khammash, Medical Sciences Department, University College of Science and Technology, Gaza Strip, Palestine
Eman Loai. Shurrab, Medical Sciences Department, University College of Science and Technology, Gaza Strip, Palestine
Mariam Nahed. Aabed, Medical Sciences Department, University College of Science and Technology, Gaza Strip, Palestine
Rana Afif. El-Malakh, Medical Sciences Department, University College of Science and Technology, Gaza Strip, Palestine
Article Tools
Follow on us
The insertion\ deletion (ID) polymorphism in intron 16 of the ACE gene is a marker for a functional polymorphism, and it is also reported to influence levels of ACE in healthy subjects. ACE ID polymorphism is associated with an elevated risk of thrombosis and may be causally associated with coronary heart disease (CHD). To investigate the association between ACE gene polymorphism and CHD in the Gaza strip population, we conducted case-control study included 260 samples comprised 160 CHD patients and 100 control subjects. Questionnaire interview was applied. Blood samples were collected in EDTA tube for DNA extraction. Polymerase Chain Reaction (PCR) used to detect ACE ID polymorphism. There was significant association between CHD and age, physical activity, education level, occupation, and family history of CHD. No significant association was observed between CHD and gender and smoking. The genotype frequencies were: ID (36.9%, 42%), DD (53.8%, 54%) and II (9.4%, 4%) in case and control groups respectively. The ACE ID allele frequencies were: I (27%, 25%) and D (72.2%, 75%) in case and control group respectively. The D allele was the most frequent allele in both groups. No association between ACE ID polymorphism and gender. The DD genotype was the most frequent in both study groups. There was no statistically significant association between the ACE ID polymorphism and CHD in Gaza strip. The results showed that there was no significant association between the ACE ID gene polymorphism and CHD in Gaza strip.
Angiotensin Converting Enzyme Gene, Coronary Heart Disease, Polymerase Chain Reaction, Polymorphism
To cite this article
Lamia'a Sobhi. Saqer, Haneen Ahmad. Khammash, Eman Loai. Shurrab, Mariam Nahed. Aabed, Rana Afif. El-Malakh, Association Between Angiotensin Converting Enzyme Gene Insertion\Deletion Polymorphism and Coronary Heart Disease in Gaza Strip, International Journal of Biomedical Materials Research. Vol. 4, No. 3, 2016, pp. 18-26. doi: 10.11648/j.ijbmr.20160403.12
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hubert C., Houot A., Corvol P. and Soubrier F. (1991) “Structure of the angiotensin I-converting enzyme gene. Two alternate promoters correspond to evolutionary steps of a duplicated gene”. Journal of Biological Chemistry, 266: 15377–15383.
Koike G., Horiuchi M., Yamada T., Szpirer C., Jacob H. and Dzau V. (1994) “Human type 2 angiotensin II receptor gene: cloned, mapped to the X chromosome, and its mRNA is expressed in the human lung”. Biochemical Biophysiological Res Communty, 203: 1842–1850.
Sayed-Tabatabaei F., Schut A., Va´squez A., Bertoli-Avella A., Hofman A., Witteman J. and Duijn V. (2005) “Angiotensin converting enzyme gene polymorphism and cardiovascular morbidity and mortality: the Rotterdam Study”. Journal of Medical Genetics, (42) 26-30.
Frederiksen H., Bathum L., Worm C., Christensen K. and Puggaard L. (2003) “ACE genotype and physical training effects: A randomized study among elderly Danes”. Aging Clinical and Exprimental Research, (15) 284-291.
Ciruzzi M., Schargrodsky H., Rozlosnik. J, Pramparo P., Delmonte H., Rudich V., Piskorz D., Negri E., Soifer L. and Vecchia C(1997)." Frequency of family history of acute myocardial infarction in patients with acute myocardial infarction". American Journal of Cardiology, 80: 122–127.
Puay Koh W., Min Yuan J., Lan Sun C., Berg D., Seow A., Hin-Peng Lee. and Mimi C. (2003) “Angiotensin I-Converting Enzyme (ACE) Gene Polymorphism and Breast Cancer Risk among Chinese Women in Singapore. ” Cancer Research, 63 (3): 573-8.
Yigit B., Bozkurt N., Narter F., Yilmaz H., Yucebas E. And Isbir T. (2007) "Effects of ACE I/D Polymorphism on Prostate Cancer Risk, Tumor Grade and Metastatis". International journal of cancer research and treatment, 27 (2) 933-936.
Cardoso R., Nogueira A., Salis L., Urmenyi T., Silva R., Moura-Neto R., Pereira B., Rondinelli E. and Silva N. (2008) “The association of ACE gene D/I polymorphism with cardiovascular risk factors in a population from Rio de Janeiro”. Brazilian Journal of Medical and Biological Research, (41) 512-518.
Ramachandran V., Ismail P., Stanslas J., Shamsudin N., Moin S. and Mohd Jas R. (2008) “Association of insertion/deletion polymorphism of angiotensin-converting enzyme gene with essential hypertension and type 2 diabetes mellitus in Malaysian subjects”. Journal of Renin-Angiotensin-Aldosterone system, 9 (4) 208-214.
Shaikh R., Shahid S., Mansoor Q., Ismail M. and Azhar A. (2014) Genetic variants of ACE (Insertion /Deletion) and AGT (M268T) genes in patients with diabetes and nephropathy.” Journal of Renin-Angiotensin-Aldosterone System, 15 (2): 124-130.
Zhou T., Yin S. and Qin Y. (2014) “Association between angiotensin-converting enzyme insertion/deletion gene polymorphism and end-stage renal disease susceptibility”. Journal of Renin-Angiotensin-Aldosterone System, 15 (1) 22-31.
Akhund S. and Avan B. (2011) “Development and pretesting of an information, education and communication (IEC) focused antenatal care handbook in Pakistan”. Biomedical Resarch Notes, 4 (91) 500-1750.
Ruiz-Ortega M, Ruperez M, Esteban V, Egido J. (2003) “Molecular mechanisms of angiotensin II-induced vascular injury”. Current Hypertension Reports, 5: 73–79.
Chizynski K., Cieplucha E. (2007). The frequency of appearance of the ID ACE genetic polymorphism in patients with previous myocardial infarction in Polish population. Clinical and Experimental Medical Letters; 48 (3): 173-179.
Dikmen M., Gunes H., Degirmenci I., Ozdemir G. and Basaran A. (2006). Are the Angiotensin-Converting Enzyme gene and activity risk factors for Stroke?. Arquivos Neuropsiquiatr, 64 (2) 211-216.
Erhardt L. (2009). Cigarette Smoking: An undertreated risk factor for cardiovascular disease. Atherosclerosis, 205: 23-32.
Gersh J., Karen S., Bongani M. and Salim Y. (2010). The epidemic of cardiovascular disease in the developing world global implications. European Heart Journal Advance Access, 31 (6): 642-650.
Rich-Edwards JW., Manson JAE., Hennekens CH. and Buring JE. (1995) “The primary prevention of coronary heart disease in women. ”The New England Journal of Medicine, 332: 1758–1766.
Jousilahti P., Vartiainen E., Tuomilehto J. and Puska P.(1999) “Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14 786 middle-aged men and women in Finland.” Circulation, 99 (9): 1165-72.
Izadnegahdar M., Singer J., Lee M., Gao M., Thompson C. and Kopec J. (2014) “Do younger women fare worse? Sex differences in acute myocardial infarction hospitalization and early mortality rates over ten years”. Journal of Womens Health, 23 (1): 10-17.
Pilote L., Dasgupta K., Guru V., Humphries K., McGrath J., Norris C., Rabi D., Tremblay J., Alamian A., Barnett T., Cox J., Ghali W., Grace S., Hamet P., Ho T., Kirkland S., Lambert M., Libersan D., O'Loughlin J., Paradis G., Petrovich M. and Tagalakis V. (2007). “A compre¬hensive view of sex-specific issues related to car¬diovascular disease. ” Canadian Medical Association Journal 176 (6): S1–S44.
Setji T, Brown A. (2007) “Polycystic Ovary Syndrome: diagnosis and treatment.” American Journal Medicine.; 120 (10): 128-32.
Sozzi F., Danzi G., Foco L., Ferlini M., Tubaro M. and Galli M. (2007) “Myocardial infarction in the young: a sex-based comparison” Coronary Artery Disease, 18 (6): 429–431.
Charchar FJ., Tomaszewski M., Lacka B., Zakrzewski J., Zukowska-Szczechowska E., Grzeszczak W. and Dominiczak AF. (2004) “Association of the human Y chromosome with cholesterol levels in the general population.” Arteriosclerosis, Thrombosis, and Vascular Biology, 24: 308–312.
Wu FC. and von Eckardstein A. (2003) “Androgens and coronary artery disease.” Endocrine Reviews; 24: 183–217.
Muller M., van A., Bots M., Grobbee D., Lamberts S. and van Y. (2004) “Endogenous sex hormones and progression of carotid atherosclerosis in elderly men. ” Circulation, 109: 2074–2079.
Mesalic L., Tupkovic E., Kendic S. and Balic D. (2008) “Correlation between hormonal and lipid status in women in menopause. ”Bosnian journal of basic medical sciences, 8 (2): 188-192.
Bonithon-Kopp C., Scarabin P., Darne B., Malmejak A. and Guize L.(1990) “Menopause-related changes in lipoproteins and some other cardiovascular risk factors” International Journal of Epidemiology, 19: 42–48.
Shahar E., Folsom A., Salomaa V., Stinson V., McGovern P. Shimakawa T., Chambless L. and Wu K. (1996). For the atherosclerosis risk in communities (ARIC) study investigators. relation of hormone replacement therapy to measures of plasma fibrinolytic activity. Circulation, 93: 1970–1975.
Mujica V., Urzua A., Leiva E., Diaz N., Moore-Carrasco R. and Vasquez M. (2010). Intervention with education and exercise reverses the metabolic syndrome in adults. journal american society hypertension, 4: 148–153.
Britton A. and McPherson K. (2002) Monitoring the Progress of the 2010 Target for Coronary Heart Disease Mortality: Estimated consequences on CHD Incidence and Mortality from Changing Prevalence of Risk Factors. National Heart Forum: 1-60.
Taylor R., Brown A., Ebrahim S., Jolliffe J., Noorani H. and Rees K. (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. American Journal of Medicine, 116: 682-692.
Tamamizu-Kato S., Yiu Wong J., Jairam V., Uchida K., Raussens V., Kato H., Ruysschaert JM, and Narayanaswami V. (2007) Modification by Acrolein, a Component of Tobacco Smoke and Age-related Oxidative Stress, Mediates Functional Impairment of Human Apolipoprotein E. Biochemistry. 17; 46 (28): 8392–8400.
Gossett L., Johnson H., Piper M., Fiore M., Baker T. and Stein J. (2009) “Smoking intensity and lipoprotein abnormalities in active smokers. ”Journal of Clinical Lipidology, 3 (6): 372-378.
Hunter K., Garlick P., Broom I.,. Anderson S. and Nurlan M.(2001) “Effects of smoking and abstention from smoking in fibrinogen synthesis in humans”. Clinical Science, 100 (4): 459-65.
Barua RS, Ambrose JA, Eales-Reynolds LJ, DeVoe MC, Zervas JG, Saha DC(2002) “Heavy and light cigarette smokers have similar dysfunction of endothelial vasoregulatory activity: an in vivo and in vitro correlation,” Journal of the American College of Cardiology 39 (11): 1758-63.
Hakovirta M. and Rantalaiho, M. (2012) “Economic inequality in children's everyday life, Kela. ”Helsinki: The Social Insurance Institution of Finland, Studies in social security and health 124; 143.
Layte R., McGee H., Quail A., Rundle K., Cousins G. and Donnelly C. (2006) “The Irish study of sexual health and relationships (ISSHR). ”Dublin: Crisis Pregnancy Agency and Department of Health and Children.
Arnold CL, Davis TC, Berkel HJ, Jackson RH, Nandy I, London S. (2001) Smoking status, reading level and knowledge of tobacco effects among low-income pregnant women. Preventive Medicine; 32: 313-320.
Leigh J. (1998) “Parents' schooling and the correlation between education and frailty. ”Economics of Education Review, 17 (3), 349-358.
Vereecken C., Keukelier E. and Maes L. (2004). “Influence of mother's educational level on food parenting practices and food habits of young children.” Appetite, 43 (1): 93-103.
Miech R. and Chilcoat H., (2005) “Maternal education and adolescent drug use: A longitudinal analysis of causation and selection over a generation. ”Social Science and Medicine, 60: 725-735.
Zlot AI., Valdez R., Han Y., Silvey K. and Leman RF. (2010) “Influence of Family History of Cardiovascular Disease on Clinicians’ Preventive Recommendations and subsequent adherence of patients without cardiovascular disease.” Public Health Genomics, 13: 457-466.
Rashed L., Abdel Hay R., Mahmoud R., Hasan N., Zahra A. and Fayez S. (2015) “Association of Angiotensin-Converting Enzyme (ACE) Gene Polymorphism with Inflammation and Cellular Cytotoxicity in Vitiligo Patients. ” PLoS ONE 10 (7): 1-10.
Semmame O., Chellat D., Ziada H., Benchabi Y., Satta D. and Abadi N. (2015) “The Relationship Between the Insertion/Deletion Polymorphism of the Angiotensin- Converting Enzyme Gene and Myocardial Infarction in Algerian Population. ”International Journal of Pharmaceutical Sciences Review and Research, 35 (2): 156-161.
Al-Serri A Ismael FG Al-Bustan S and Al-Rashdan I. (2015) “Association of the insertion allele of the common ACE gene polymorphism with type 2 diabetes mellitus among Kuwaiti cardiovascular disease patients. ”Journal of the Renin-Angiotensin Aldosterone System, 16 (4): 910-916.
AlBacha Jd., Khoury M., Mouawad C., Haddad K., Hamoui S., Azar A., Fajloun Z and Makdissy N. (2015) “High Incidence of ACE/PAI-1 in Association to a Spectrum of Other Polymorphic Cardiovascular Genes Involving PBMCs Proinflammatory Cytokines in Hypertensive Hypercholesterolemic Patients: Reversibility with a Combination of ACE Inhibitor and Statin. ” PLoS ONE 10 (5): 1-24.
Alharbi Kh., Kashour T., Al-Hussaini W., Al-Nbaheen M., Mohamed S., Hasanato R., Tamimi W., Al-Naami M. and Ali Khan I. (2013) “Association of angiotensin converting enzyme gene insertion/ deletion polymorphism and familial hypercholesterolemia in the Saudi population Lipids in Health and Disease.” Lipids Health Disease 12 (177): 1-5.
Inanir S., YIgIt S., CamCelIke F., AteS O., ErdOgan taYcan S., NurSal Y. and Inanir A. (2016) “Relationship between major depressive disorder and ACE gene I/D polymorphism in a Turkish population. ”Archives of Clinical Psychiatry, 43 (2): 27-30.
Shanmuganathan R., Kumaresan R. Giri P. (2015) “Prevalence of angiotensin converting enzyme (ACE) gene insertion /deletion polymorphism in South Indian population with hypertension and chronic kidney disease.” Journal of Postgraduate Medicine, 61 (4): 230-234.
Carmen D., Claudia B., Zsuzsanna G., Alina G. and Horea G. (2011) “Association Between Angiotensin Converting Enzyme Gene Insertion (I) /Deletion (D) Polymorphism and Secondary Arterial Hypertension in a Romanian Children Population. Acta Medica Marisiensis, 4 (2247): 1-4.
Zhou L., Xi B., Wei Y., Shen W. and Yixiang Li. (2012) “Meta-analysis of the association between the insertion/deletion polymorphism in ACE gene and coronary heart disease among the Chinese population.” Journal of the Renin-Angiotensin- Aldosterone System, 13 (2): 296– 304.
Al-Jebouri M. and Al-Alwani H. (2015) “Angiotensin I-Converting Enzyme Gene Polymorphism In Patients With Chronic Renal Failure”. World Journal of Pharmaceutical Research, 4 (1): 1-11.
Tseluyko VI., Litvinova IA. and Kravchenko NA. (2000) “Angiotensin-converting enzyme gene polymorphism in patients with hypertrophic cardiomyopathy.” Ukrainian Journal of Cardiology, 3: 37-41.
Bekmetova F., Ravshanbek D., Alexander B., Kurbanov D., Liliya E. and Shek K. (2012) “Association between ACE Gene I/D Polymorphism and Unstable Angina in Uzbek Patients with Family History of Coronary Heart Disease”. International Journal of Biomedicine 2 (4) 275-278.
Malygina N., Kostomarova I., Krivodubskaya T. and Muromova SI. (2000) “Analysis of the angiotensin-converting enzyme gene polymorphism in patients with coronary heart disease and hypertension” Cardiology, 4: 2-19.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186