Institut für Klinische Chemie und Laboratoriumsmedizin, Ernst-Moritz-Arndt Universität Greifswald, Greifswald, Germany.
Horm Metab Res. 2010 Jun;42(6):392-9. doi: 10.1055/s-0030-1247545. Epub 2010 Feb 15.
The renin-angiotensin-aldosterone system plays a key role in the regulation of human blood pressure. The aldosterone-to-renin ratio (ARR) is widely accepted for screening the primary hyperaldosteronism (PAL). Various cutoffs for positive PAL screening have been defined in patient cohorts from endocrinological referral centers and primary care. However, the distribution of the ARR in the general population is largely unknown. We aim to provide reference ranges for plasma aldosterone concentration (PAC), plasma renin concentration (PRC), and the ARR for the general population of north-east Germany. A cohort of 3 300 subjects participated in the first follow-up of the longitudinal, population-based Study of Health in Pomerania (SHIP). PAC and PRC were measured by radioimmunometric procedures. The reference interval was defined as the central 95% range between the 2.5(th) and 97.5(th) percentiles. A reference population comprising 1,347 healthy subjects was selected. Sex and age-specific (25-54 and 55-74 years) reference ranges are presented. The upper reference limit for the ARR was 14.2 and 20.3 in younger, and 22.4 and 25.5 in older men and women, respectively. Time of blood sampling had no influence on the ARR, while beta blockers, and agents acting on the renin-angiotensin system were associated with higher and lower ARR, respectively. Our upper reference limit for the ARR is clearly lower than previously reported values from studies of hypertensive patients in primary care or hypertension referral centers. We confirm that PAC and PRC are associated with various factors, including sex, age, intake of estrogen, and various antihypertensive medications.
肾素-血管紧张素-醛固酮系统在调节人体血压方面发挥着关键作用。醛固酮与肾素比值（ARR）广泛用于原发性醛固酮增多症（PAL）的筛查。在来自内分泌科转诊中心和初级保健的患者队列中，已经定义了各种用于阳性 PAL 筛查的截止值。然而，ARR 在普通人群中的分布在很大程度上尚不清楚。我们旨在为德国东北部普通人群的血浆醛固酮浓度（PAC）、血浆肾素浓度（PRC）和 ARR 提供参考范围。一个由 3300 名受试者组成的队列参加了波罗的海健康研究（SHIP）的首次随访，该研究是一项纵向的基于人群的研究。PAC 和 PRC 通过放射免疫测定法进行测量。参考区间定义为 2.5（th）和 97.5（th）百分位数之间的中央 95%范围。选择了一个由 1347 名健康受试者组成的参考人群。呈现了按性别和年龄（25-54 岁和 55-74 岁）划分的参考范围。ARR 的上参考限值分别为年轻男性和女性的 14.2 和 20.3，以及老年男性和女性的 22.4 和 25.5。采血时间对 ARR 没有影响，而β受体阻滞剂和作用于肾素-血管紧张素系统的药物分别与较高和较低的 ARR 相关。我们的 ARR 上参考限值明显低于以前在初级保健或高血压转诊中心的高血压患者研究中报告的数值。我们确认 PAC 和 PRC 与多种因素相关，包括性别、年龄、雌激素摄入和各种降压药物。
