Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany.
Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
Atherosclerosis. 2016 Sep;252:88-96. doi: 10.1016/j.atherosclerosis.2016.07.905. Epub 2016 Jul 17.
The exact mechanism of premature atherosclerosis in diabetes is still unclear. Inappropriate activation of the renin-aldosterone-angiotensin system may be an important risk factor for cardiovascular disease. We investigated whether renin and aldosterone are associated with vasoactive peptides midregional-pro atrial natriuretic peptide (MR-proANP) and midregional-pro adrenomedullin (MR-proADM), or with intima media thickness (IMT) as a marker for early atherosclerotic alterations in the general community and in subjects with type 2 diabetes.
In 1261 participants in the KORA F4 study, the associations of renin, aldosterone and aldosterone to renin ratio with MR-proANP, MR-proADM and IMT were assessed using linear regression models stratified for the presence of prediabetes and type 2 diabetes.
After adjustment for confounding factors, an inverse association of MR-proANP with renin (p = 0.002) and aldosterone (p = 0.021) and a direct association of MR-proADM with renin (p < 0.001) and aldosterone (p = 0.019) were seen in nondiabetic individuals. In diabetic subjects, there was no significant correlation of MR-proANP or MR-proADM with renin or aldosterone. Renin and aldosterone were not directly associated with IMT in non-diabetic subjects and the total cohort, whereas aldosterone was associated with IMT in diabetic participants (p = 0.005).
This study shows associations between renin, aldosterone and MR-proANP/MR-proADM plasma levels that are altered in type 2 diabetes. Plasma renin and aldosterone are not independent biomarkers for early atherosclerotic damages of the carotid arteries in the general community.
糖尿病患者发生过早动脉粥样硬化的确切机制仍不清楚。肾素-血管紧张素-醛固酮系统的不适当激活可能是心血管疾病的一个重要危险因素。我们研究了在普通人群和 2 型糖尿病患者中，肾素和醛固酮是否与血管活性肽中段-pro 心房利钠肽（MR-proANP）和中段-pro 肾上腺髓质素（MR-proADM）相关，或者与作为早期动脉粥样硬化改变的内膜中层厚度（IMT）相关。
在 KORA F4 研究的 1261 名参与者中，使用线性回归模型，根据是否存在糖尿病前期和 2 型糖尿病，评估了肾素、醛固酮和醛固酮与肾素的比值与 MR-proANP、MR-proADM 和 IMT 的相关性。
在调整了混杂因素后，在非糖尿病个体中，MR-proANP 与肾素（p=0.002）和醛固酮（p=0.021）呈负相关，MR-proADM 与肾素（p<0.001）和醛固酮（p=0.019）呈正相关。在糖尿病患者中，MR-proANP 或 MR-proADM 与肾素或醛固酮均无显著相关性。肾素和醛固酮与非糖尿病个体和总队列的 IMT 无直接相关性，而醛固酮与糖尿病患者的 IMT 相关（p=0.005）。
本研究显示了肾素、醛固酮与 MR-proANP/MR-proADM 血浆水平之间的关联，这些关联在 2 型糖尿病中发生改变。血浆肾素和醛固酮不是普通人群颈动脉早期粥样硬化损害的独立生物标志物。
