1. Historical perspective
Positive family history is recognized as a very risk factor for the so-called type 2 diabetes mellitus in connection with the family history with renin-angiotensin system gene polymorphisms has not been reported up to date. Family history records, clinical and biochemical data and information were developed from type 2 diabetes mellitus patients. Polymerase chain reaction was performed for angiotensin-converting enzyme genotyping and polymerase chain reaction restricted fragment length polymorphism was used for angiotensinogen genotyping. Patients with a negative family history had the higher level of triglyceride, and blood pressure whereas those with a positive family history showed younger onset age and lower of body mass these results were depending on the age.
The percentage of hypertension was lower with a respective high percentage of overweight among the patients. Patients with a positive family history and the ones with negative family history had comparable genotype. A positive family history of diabetes was not associated with rennin-angiotensin gene polymorphisms.
2. Current knowledge
First, we will consider knowledge about drugs. There are some drugs which are RAS inhibitors like angiotensin-converting (ACE) inhibitors and receptor blockers. The two drugs use different mechanisms both drugs have been proven to decrease the risk of cardiovascular and renal events.
Let us also consider the current knowledge of pancreatic renin-angiotensin systems. Pancreatic RAS plays numerous roles in the regulation of pancreatic physiology and pathophysiology. Since antagonism is capable of preventing new diabetes infection and therefore improving glycaemic control in diabetes patients. Current evidence for roles of pancreatic RAS is largely dependent on cell and animal models.
Several researchers have found that reduction of urinary albumin excretion is important in an improvement of cardiovascular prognosis. A decrease of it can be obtained by lowering arterial blood pressure.
1: Prkacin I. Angiotensin-converting enzyme gene polymorphism in patients with systemic lupus. Acta Med Croatica. 2001;55(2):73-6. PubMed PMID: 11505631.
2: Sprovieri SR, Association between polymorphisms of the renin-angiotensin system and more severe histological forms of lupus nephritis. Clin Nephrol. 2005 Jul;64(1):20-7. PubMed PMID: 16047641.
3: Pullmann R Jr, Association between systemic lupus erythematosus and insertion/deletion polymorphism of the angiotensin converting enzyme (ACE) gene. Clin Exp Rheumatol. 1999 Sep-Oct;17(5):593-6. PubMed PMID: 10544843.
4: Tselios K, Does Renin-Angiotensin System Blockade Protect Lupus Nephritis Patients From Atherosclerotic Cardiovascular Events? A Case-Control Study. Arthritis Care Res (Hoboken). 2016 Oct;68(10):1497-504. doi: 10.1002/acr.22857. Epub 2016 Aug 19. PubMed PMID: 26866934.
5: Gao R. Early Renin-angiotensin System Blockade Improved Short-term and Longterm Renal Outcomes in Systemic Lupus Erythematosus Patients with Antiphospholipid-associated Nephropathy. J Rheumatol. 2018 Feb 15. pii: jrheum.170561. doi: 10.3899/jrheum.170561. [Epub ahead of print] PubMed PMID: 29449503.
6: Lai KN Gene expression of the renin-angiotensin system in human kidney. J Hypertens. 1998 Jan;16(1):91-102. PubMed PMID: 9533422.
7: Harley JB. Linkage analysis of angiotensin-converting enzyme (ACE) insertion/deletion polymorphism and systemic lupus erythematosus. Mol Cell Endocrinol. 2001 May 25;177(1-2):81-5. PubMed PMID: 11377823.