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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue1
Subject Area: Medicine
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DOI: 10.5272/jimab.2026321.6726
Published online: 20 February 2026
Original article
J of IMAB. 2026 Jan-Mar;32(1):6726-6731
ANGIOTENSIN-CONVERTING ENZYME GENE INSERTION/DELETION POLYMORPHISM IN PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
Aneliya Avramova1
, Emil Slavov1, Resmi Ismail2, Todor Valkov2, Dimitar Petkov2, 3, Lyuba Miteva1,
1)Department of Molecular Biology, Immunology and Medical Genetics, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria.
2)University Hospital for Active Treatment "Trakia", Stara Zagora, Bulgaria.
3)Department "Special Surgery", Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria.
ABSTRACT:
Purpose: Peripheral Arterial Occlusive Disease (PAOD) is a vascular disease associated with high morbidity and mortality worldwide. The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism (rs4340) has been suggested as a potential risk factor for PAOD. This study aimed to examine the association of the ACE I/D polymorphism and PAOD risk in Bulgarian patients.
Materials/Methods: This case-control study included 85 patients with PAOD and 394 controls. Genomic DNA was isolated from peripheral blood, and ACE genotyping was performed using classical end-point polymerase chain reaction.
Results: ACE genotype frequencies were similar between PAOD patients (DD: 0.317; ID: 0.459; II:0.224) and controls (DD: 0.345; ID: 0.495; II: 0.160; p=0.368), as well as the allelic frequencies (p=0.274). Further analysis based on the clinical manifestation of the disease did not reveal a significant association with the ACE I/D polymorphism. However, a tendency for a higher frequency of the DD-genotype was observed among cases with arterial hypertension (0.348 vs. 0.188) or with atrophic changes (0.412 vs. 0.294), compared to patients without these conditions.
Conclusion: There was no significant association between the ACE I/D polymorphism and the development of PAOD in the Bulgarian population. However, carrying the DD-genotype might contribute to the clinical characteristics of PAOD.
Keywords: Peripheral Arterial Occlusive Disease, ACE I/D polymorphism, rs4340, hypertension,
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Please cite this article as: Avramova A, Slavov E, Ismail R, Valkov T, Petkov D, Miteva L. Angiotensin-converting enzyme gene insertion/deletion polymorphism in peripheral arterial occlusive disease. J of IMAB. 2026 Jan-Mar;32(1):6726-6731. [Crossref - 10.5272/jimab.2026321.6726]
Correspondence to: Aneliya Avramova, Department of Molecular Biology, Immunology and Medical Genetics, Faculty of Medicine, Trakia University, Stara Zagora, 11, Armeyska Str., 6000 Stara Zagora, Bulgaria; E-mail: ani85avramova@yahoo.com
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Received: 30 July 2025
Published online: 20 February 2026