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Angiotensin-converting enzyme in diabetes mellitus dependence on metabolic aberration.

Serum angiotensin-converting enzyme (s-ACE) was measured in 56 diabetic outpatients and in 6 juvenile insulin dependent diabetics who developed mild to moderate ketosis after insulin withdrawal. In the outpatients mean s-ACE was increased by 24% compared to healthy controls. However, development of ketosis resulted in significant reduction of s-ACE from 29.2 +/- 1.6 U/ml (+/- SEM) to 23.1 +/- 1.9 U/ml (p less than 0.05). In addition, a clearcut inverse correlation was observed between blood-3-hydroxybutyrate rise and s-ACE decrement (p less than 0.01). The reduction observed may be mediated through the metabolic acidosis.