Joint effects of hypertension, smoking, dyslipidemia and obesity and angiotensin-converting enzyme DD genotype on albuminuria in Taiwanese patients with type 2 diabetes mellitus

Objective: We investigated the individual and joint effects of hypertension, smoking, dyslipidemia, and obesity and angiotensin-converting enzyme (ACE) DD genotype on albuminuria in Taiwanese type 2 diabetic patients. Designs and methods: ACE genotypes were determined in 519 (287 men and 232 women) patients aged 58.5 (SD: 9.0) years. Among them, 240 had albuminuria (urinary albumin-to-creatinine ratio > 30 μg/mg). Logistic regression was used to evaluate the individual and joint effects of risk factors and DD classified by two-by-four table. Results: The adjusted odds ratios were significant for hypertension, smoking and obesity but not for DD and dyslipidemia in models evaluating individual effects. However, while analyzing the joint effects of DD and hypertension, smoking, dyslipidemia and obesity, the respective adjusted odds ratios were 3.253 (1.261-8.391), 3.016 (1.086-8.376), 2.385 (1.010-5.630) and 2.508 (1.117-5.631). Conclusion: Hypertension, smoking, dyslipidemia and obesity jointly play an important role with DD genotype in mediating albuminuria.