Aldehyde dehydrogenase 2 rs671 polymorphism may be associated with an increased risk of coronary atherosclerosis among patients with type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a risk for coronary atherosclerosis. However, some T2DM patients are prone to coronary atherosclerosis, while another group do not suffer from it. Are there any risk factors for T2DM patients to develop coronary atherosclerosis? Aldehyde dehydrogenase 2 (ALDH2) is an important enzyme for the oxidation metabolism of aldehyde substances, and it is related to coronary atherosclerosis. The aim of this study is to analyze the relationship between ALDH2 rs671 polymorphism and the risk of coronary atherosclerosis in T2DM. 701 T2DM patients from January 2019 to February 2024 were retrospectively analyzed, included 364 patients with coronary atherosclerosis [ ≥ 50% coronary stenosis on coronary angiography (CAG)] and 337 controls ( < 50% coronary stenosis). Clinical data collected including gender, age, body mass index (BMI), history of smoking, history of alcohol consumption, hypertension, and lipid level test results. The relationship between ALDH2 rs671 polymorphism and coronary atherosclerosis risk was analyzed. The frequency of the ALDH2 rs671 G/G genotype was lower (47.3% vs. 62.9%, p < 0.001), whereas the G/A genotype (43.1% vs. 31.8%, p = 0.002) and A/A genotype (9.6% vs. 5.3%, p = 0.044) were higher in the patients with coronary atherosclerosis than those in the controls. Logistic regression analysis showed that overweight (odds ratio (OR): 1.837, 95% confidence interval (CI): 1.312 –2.573, p < 0.001), smoking (OR: 1.644, 95% CI: 1.066–2.535, p = 0.025), hypertension (OR: 2.240, 95% CI: 1.607–3.122, p < 0.001), dyslipidemia (OR: 1.809, 95% CI: 1.268–2.581, p = 0.001), ALDH2 rs671 G/A or A/A genotype (G/A + A/A vs. G/G, OR: 1.579, 95% CI: 1.131–2.203, p = 0.007) were associated with coronary atherosclerosis in T2DM. Overweight, hypertension, dyslipidemia, ALDH2 rs671 G/A or A/A genotype were associated with coronary atherosclerosis in T2DM patients.