Messerli F H, Kuchel O, Nowaczynski W, Seth K, Honda M, Kubo S, Boucher R, Tolis G, Genest J
Circulation. 1976 Mar;53(3):406-10. doi: 10.1161/01.cir.53.3.406.
In 19 control subjects, 33 patients with essential hypertension and normal plasma renin activity (PRA) and 11 patients with low PRA, secretory rates of 18-hydroxy-11-deoxy-corticosterone (18-OH DOC), 11-deoxycorticosterone (DOC) and corticosterone were measured. Patients with low PRA were significantly older and had higher arterial pressure and slightly lower plasma potassium levels than patients with normal PRA. Mean 18-OH DOC secretion rate was higher in patients with normal PRA (603 +/- 112 SEM mug/24 hr) than in control subjects (219 +/- 19) and considerably higher (P less than 0.001) in patients with low PRA (1800 +/- 472). DOC and corticosterone secretion rates were within normal limits in most hypertensive patients. Plasma aldosterone was significantly higher in the hypertensive population than in control subjects whereas no significant difference was observed between the low- and normal-renin groups. A significant (P less than 0.01) mutual positive correlation was found between the secretion rates of 18-OH DOC, DOC and corticosterone in patients with low plasma renin activity. In contrast, there was no correlation between the secretion rates of the three mineralocorticoids in control subjects and patients with normal plasma renin activity. These data suggest a biosynthetic variation of the mineralocorticoid pathways in essential hypertension.
对19名对照受试者、33名原发性高血压且血浆肾素活性（PRA）正常的患者以及11名PRA较低的患者，测量了18 - 羟基 - 11 - 脱氧皮质酮（18 - OH DOC）、11 - 脱氧皮质酮（DOC）和皮质酮的分泌率。PRA较低的患者比PRA正常的患者年龄显著更大，血压更高，血浆钾水平略低。PRA正常的患者平均18 - OH DOC分泌率（603±112 SEM微克/24小时）高于对照受试者（219±19），而PRA较低的患者则更高（P＜0.001）（1800±472）。大多数高血压患者的DOC和皮质酮分泌率在正常范围内。高血压人群的血浆醛固酮显著高于对照受试者，而低肾素组和正常肾素组之间未观察到显著差异。血浆肾素活性较低的患者中，18 - OH DOC、DOC和皮质酮的分泌率之间存在显著的（P＜0.01）相互正相关。相比之下，对照受试者和血浆肾素活性正常的患者中，这三种盐皮质激素的分泌率之间无相关性。这些数据提示原发性高血压中盐皮质激素途径存在生物合成变异。
