Clotet Sergi, Riera Marta, Pascual Julio, Soler Maria José
Hospital del Mar-IMIM.
Hospital del Mar-IMIM
Am J Physiol Renal Physiol. 2016 May;310(10):F945-F957. doi: 10.1152/ajprenal.00292.2015. Epub 2016 Mar 9.
The incidence and progression of kidney diseases are influenced by sex. The renin-angiotensin system (RAS) is an important regulator of cardiovascular and renal function. Sex differences in the renal response to RAS blockade have been demonstrated. Circulating and renal RAS has been shown to be altered in type 1 and type 2 diabetes; this enzymatic cascade plays a critical role in the development of diabetic nephropathy (DN). Angiotensin converting enzyme (ACE) and ACE2 are differentially regulated depending on its localization within the diabetic kidney. Furthermore, clinical and experimental studies have shown that circulating levels of sex hormones are clearly modulated in the context of diabetes, suggesting that sex-dependent RAS regulation may be also be affected in these individuals. The effect of sex hormones on circulating and renal RAS may be involved in the sex differences observed in DN progression. In this paper we will review the influence of sex hormones on RAS expression and its relation to diabetic kidney disease. A better understanding of the sex dimorphism on RAS might provide a new approach for diabetic kidney disease treatment.
肾脏疾病的发病率和进展受性别影响。肾素-血管紧张素系统（RAS）是心血管和肾功能的重要调节因子。肾对RAS阻断的反应存在性别差异已得到证实。1型和2型糖尿病患者的循环和肾脏RAS已显示发生改变；这一酶促级联反应在糖尿病肾病（DN）的发展中起关键作用。血管紧张素转换酶（ACE）和ACE2根据其在糖尿病肾脏中的定位受到不同调节。此外，临床和实验研究表明，糖尿病患者体内性激素的循环水平明显受到调节，这表明这些个体的性别依赖性RAS调节可能也会受到影响。性激素对循环和肾脏RAS的影响可能与DN进展中观察到的性别差异有关。在本文中，我们将综述性激素对RAS表达的影响及其与糖尿病肾病的关系。更好地理解RAS的性别二态性可能为糖尿病肾病的治疗提供新方法。
