Plasma aldosterone concentration in the patient with diabetes mellitus
Plasma aldosterone concentration in the patient with diabetes mellitus
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DOI：
10.1111/j.1523-1755.2004.00524.x
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发表时间：
2004-04-01
影响因子：
19.6
通讯作者：
Fisher, NDL
中科院分区：
文献类型：
--
作者：
Hollenberg, NK;Stevanovic, R;Fisher, NDL
背景。微血管和大血管水平的血管损伤在糖尿病患者中起着至关重要的作用。许多 1 型糖尿病患者肾素系统激活的证据提出了醛固酮（广泛认为是血管损伤的一个促成因素）可能发挥作用的可能性。方法。我们检查了 58 名 1 型糖尿病受试者和 64 名年龄匹配的正常对照受试者的肾素-血管紧张素-醛固酮系统 (RAAS) 状态。所有研究均以固定的钠（200 mmol/天）和钾（100 mmol/天摄入量）为基础进行，并在上午 8: 00 取样。米。避免昼夜节律的影响。结果。糖尿病患者血浆肾素活性（PRA）（P < 0.01）、血浆血管紧张素II浓度（P < 0.01）和血浆醛固酮浓度（P < 0.001）升高。血管紧张素受体阻滞剂坎地沙坦对糖尿病患者血浆醛固酮浓度的显着影响强烈表明肾素系统激活是血浆醛固酮浓度升高的原因。结论。在组织水平上用药物阻断醛固酮的作用对于糖尿病患者尤其有用。应调整阻断肾素-血管紧张素系统 (RAS) 的药物剂量，以最大限度地降低血浆醛固酮浓度。
Background. Vascular injury at the microvascular and macrovascular levels plays a crucial role in the patient with diabetes mellitus. Evidence for renin-system activation in many patients with type 1 diabetes mellitus has raised the possibility that aldosterone-widely recognized as a contributor to vascular injury-could play a role.Methods. We examined the state of the renin-angiotensin-aldosterone system (RAAS) in 58 subjects with type 1 diabetes mellitus and 64 age-matched normal control subjects. All studies were performed on a fixed sodium (200 mmol/day) and potassium (100 mmol/day intake), and samples were drawn at 8: 00 a. m. to avoid the influence of circadian rhythms.Results. The patient with diabetes mellitus showed an increase in plasma renin activity (PRA) (P < 0.01), plasma angiotensin II concentration (P < 0.01), and plasma aldosterone concentration (P < 0.001). A striking influence of the angiotensin receptor blocker, candesartan, on plasma aldosterone concentration in the patients with diabetes mellitus suggested strongly that renin-system activation is responsible for the elevated plasma aldosterone concentration.Conclusion. Pharmacologic interruption of the effects of aldosterone at the tissue level could be especially useful in patients with diabetes mellitus. The dose of agents that block the renin-angiotensin system (RAS) should be adjusted to maximize the fall in plasma aldosterone concentration.