What role does obesity play in the ACE/ACE II ratio?

• A. It improves the ratio
• B. It has no effect
• C. It negatively affects the ratio
• D. It stabilizes the ratio

Answer: (C)

Obesity plays a critical role in the ACE/ACE II ratio, particularly in the context of the renin-angiotensin system, which is involved in blood pressure regulation and fluid balance. In individuals with obesity, there is often an upregulation of angiotensin-converting enzyme (ACE) levels and activity. This upregulation leads to increased conversion of angiotensin I to angiotensin II, a powerful vasoconstrictor that can contribute to hypertension and other cardiovascular issues.

As obesity increases the levels of ACE, the ratio of ACE to ACE II is negatively affected because ACE II, which generally has protective cardiovascular effects by converting angiotensin II to angiotensin 1-7 (a vasodilator), is not increased to the same extent. Consequently, the imbalance between increased ACE and relatively stable or decreased ACE II leads to a higher ACE/ACE II ratio, promoting a state that favors vasoconstriction and pro-inflammatory processes.

Understanding the interaction between obesity and the ACE/ACE II ratio is crucial for better management of associated disorders, like hypertension and cardiovascular diseases, especially in obese patients.