MP429LEVELS OF SERUM ANGIOTENSIN-CONVERTING ENZYME TYPE 2 (ACE2) ARE ASSOCIATED WITH INCREASED INSULIN RESISTANCE INDEPENDENTLY OF ALBUMINURIA IN TYPE 2 DIABETES

Introduction and Aims: Angiotensin-converting enzyme type 2 (ACE2) is a novel ACE homologue, which has actions that counterbalance Ang II: vasodilatation, antiproliferation, and apoptosis functions. In the context of diabetes, ACE2s implication in cardiovascular and renal pathophysiology has become particularly important in recent years. Recent studies associate ACE 2 with the presence of albuminuria in diabetic patients indicating that ACE2 may participate as compensatory mechanism. On the other hand, clinical studies reported higher levels of ACE2 in insulin-resistant subjects. In type 2 diabetic (DM2) patients, increased urinary albumin excretion is strongly associated with insulin resistance. The aim of this study is to evaluate de role of ACE 2 in DM2 patients keeping in mind the association between albuminuria and insulin resistance. Methods: We performed a cross-sectional and case-control study. 61 patients with DM2 and an estimated glomerular filtration rate by MDRD greater than 60 mL/min/1,73m2 were studied. 31 patients in the control group had category A1 of albuminuria; and 30 patients in the case group had category A2 of albuminuria (urine albumin/creatinine ratio (ACR): 30-300 mg/g). Age, gender, diabetes duration, renin-angiotensin system inhibitors, smoking habit, HbA1c and vascular disease history were documented. Serum ACE2 activity was measured in all patients. Insulin resistance was assessed by homeostasis model assessment for insulin resistance (HOMA-IR) index and urinary albumin excretion by urine ACR. SPSS 20.0 software was used for statistical analysis.