the study of relationship between mthfr c677t and ace i/d variants and the risk of diabetic nephropathy in type 2 diabetes mellitus

background: in 30 to 40% of patients with type 2 diabetes mellitus (t2dm) nephropathy is developed. the aim of the present study was to find the synergistic effect of two polymorphisms of methylenetetrahydrofolate reductase (mthfr) c677t and angiotensin converting enzyme insertion/ deletion (ace i/d) polymorphism on the risk of diabetic nephropathy and its progression. methods:   in a case-control study, the mthfr c677t and ace i/d  were detected using pcr and pcr-rflp, respectively in 72 patients with macroalbuminuria, 68 patients with microalbuminuria and 72 normoalbuminuric patients. the data were analyzed using spss. results: in the presence of t allele of mthfr the risk of microalbuminuria increased 1.54-fold (p=0.58). also, non significant increased risk of macroalbuminuria was observed in the presence of ace d allele (1.44-fold). however, in the presence of both mthr 677t and ace d alleles the risk of macroalbuminuria increased 4-fold (95%ci=1.1-14.5, p=0.035). also, in the presence of both alleles the risk of progression from micro- to macro-albuminuria increased 2.07-fold (p=0.27). conclusion: the results of present study indicate the synergistic effect of mthfr 677t and ace d alleles on the increased risk of diabetic nephropathy and its progression.