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- Title
The Increase of Plasma Aldosterone Concentrations Were Correlated with Insulin Resistance in Patients with Type 2 Diabetes Mellitus.
- Authors
Yamashita, Maki; Matsuki, Kohta; Tanabe, Jutaro; Yanagimachi, Miyuki; Murakami, Hiroshi; Tando, Yusuke; Ogawa, Yoshiji; Tamasawa, Naoki; Suda, Toshihiro
- Abstract
Recently many experimental and clinical evidences demonstrated that renin-angiotensin-aldosterone system(RAAS)played an important cause of the insulin resistance and impaired glucose tolerance. To evaluate the RAAS activity in type 2 diabetics, we determined plasma levels of renin activity (PRA), aldosterone concentration (PAC) and their ratio (PAC/PRA), and compared with non-diabetic control subjects. We examined RAAS activity in 114 subjects with type 2 diabetes mellitus (55 males, 59 females, nephropathy<stage3B) and 23 age- and gender-matched non-diabetic control subjects. None of these subjects took ACE-I,ARB, diuretics and I]-blocker. Plasma samples were obtained in the morning after the rest on bed for 30-min. Functioning adrenal tumors such as primary aldosteromism, Cushing syndrome, pheochromocytoma etc, were excluded due to endocrinological examinations. There was no statistical difference between type 2 diabetics and non-diabetic controls in age, gender, BMI and prevalence of hypertension. PAC and ARR in type 2 diabetics were significantly higher than those of non-diabetics(9.6±5.0 vs. 7.6±4.1 pg/ml;p<0.05, 13.7±15.6 vs. 7.0±5.4;p<0.05, respectively). PAC significantly correlated with BMI(rs=0.274;p<0.01) and 24hr-urinary C-peptide secretion(U-CPR, rs=0.310;p<0.05), and had tendency with fasting (F)-IRI(rs=0.209;p<0.1) in type 2 diabetics. However there was no significant correlation between PAC and BMI in non-diabetics. There was no significant correlation between ARR and age, BMI, duration, stage of nephropathy, 24hr-creatinine clearance, U-CPR and F-IRI in type 2 diabetics. Our study demonstrated significant increases of PAC and ARR in type 2 diabetics compared with non-diabetics. The increase of ARR in type 2 diabetics was suggested to be caused by the increase of PAC, but not the decrease of PRA (renin-independent). Since there were positive correlation between PAC and BMI, U-CPR and F-IRI, insulin resistance was thought to play an important role in the activity of angiotensin-aldosterone system in type 2 diabetics. These results suggested the importance to inhibit RAAS activity in treatment with type 2 diabetes mellitus and insulin resistance.
- Publication
Diabetes, 2007, Vol 56, pA671
- ISSN
0012-1797
- Publication type
Academic Journal