ECE2023 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (159 abstracts)
Angiotensin-Converting Enzyme (ACE) Level, But Not ACE Gene Polymorphism, Is Associated with Prognosis of COVID-19 Infection: Connection Between Type 2 Diabetes, Hypertension and Renin-Angiontensin-Aldosteron System
Onur Elbasan 1 , Feyza Bayram 2 , Ceyda Dinçer Yazan 3 , Tugce Apaydin 3 , Saida Dashdamirova 3 , Hamza Polat 2 , Ebru Arslan 2 , İpek Yılmaz 2 , Nastaran Karimi 2 , Buket Ertürk Şengel 4 , Sultan Yılmaz 5 , Ömer Faruk Çelik 5 , Pınar Ata 2 , Goncagül Haklar 5 & Hülya Ilıksu Gözü 3
1Sinop Ataturk State Hospital, Endocrinology and Metabolism, Sinop, Turkey; 2Marmara University School of Medicine, Medical Genetics, İstanbul, Turkey; 3Marmara University School of Medicine, Endocrinology and Metabolism, İstanbul, Turkey; 4Marmara University School of Medicine, Infectious Diseases and Microbiology, İstanbul, Turkey; 5Marmara University School of Medicine, Biochemistry, İstanbul, Turkey
Introduction: Renin-angiotensin-aldosterone system was shown to be activated in severe COVID-19 infection. We aimed to investigate the relation between angiotensin converting enzyme (ACE) levels, ACE gene polymorphism, type 2 diabetes (T2DM), and hypertension (HT), and the prognosis of COVID-19 infection.
Methods: Clinical features of adult patients with SARS-CoV-2 infection diagnosis were analyzed. ACE gene analysis and ACE level measurements were performed. The patients were grouped according to ACE gene polymorphism (DD, ID or II), disease severity (mild, moderate, or severe), and the use of dipeptidyl peptidase-4 enzyme inhibitor (DPP4i), ACE-inhibitor (ACEi) or angiotensin receptor blocker (ARB). Intensive care unit (ICU) admissions and mortality were also recorded.
Results: A total of 266 patients were enrolled. Gene analysis detected DD polymorphism in ACE 1 gene in 32.7% (n=87), ID in 51.5% (n=137), and II in 15.8% (n=42) of the patients. ACE gene polymorphisms were not associated with disease severity, ICU admission, or mortality. ACE level was higher in patients who died (P=0.004) or admitted to ICU (P<0.001), and in those with severe disease in comparison to mild (P=0.023) or moderate (P<0.001) cases. HT, T2DM, and ACEi/ARB or DPP4i use were not associated with mortality or ICU admission. ACE levels were similar in patients with or without HT (P=0.374) and with HT using or not using ACEi/ARB (P=0.999). It was also similar in patients having T2DM or not (P=0.062) and in those with T2DM under DPP4i or not (P=0.427). ACE level was a weak predictor of mortality, but an important predictor of ICU admission. ACE level predicted ICU admission in total (cut-off value >37.092 ng/ml, AUC:0.775, P<0.001).
| ICU admission | ACE Cut-off | Sensitivity | Specificity | AUC(SE.) | p | ||
| Absent | Present | ||||||
| HT (-) | 131 | 17 | 26.1125 | 70.0% | 80.0% | 0.777(0.084) | 0.004 |
| HT (+) ACEi/ARB (+) | 66 | 8 | 38.7225 | 50.0% | 93.0% | 0.705(0.124) | 0.106 |
| HT (+) ACEi/ARB (-) | 36 | 8 | 18.553 | 100.0% | 51.7% | 0.779(0.092) | 0.049 |
| T2DM (-) | 171 | 20 | 26.098 | 70.0% | 77.7% | 0.768(0.086) | 0.005 |
| T2DM (+) DPP-4i (-) | 50 | 9 | 17.9445 | 100.0% | 41.0% | 0.634(0.096) | 0.264 |
| Total | 233 | 33 | 37.092 | 92.5% | 52.4% | 0.775(0.053) | <0.001 |
Conclusions: Our findings suggest that higher ACE levels, but not ACE gene polymorphism or ACEi/ARB or DPP4i use, were the associated with the prognosis of COVID-19 infection. Presence of HT and T2DM, and ACEi/ARB or DPP-4i use was shown not to be associated with mortality or ICU admission.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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