Grotevendt A, Wallaschofski H, Reincke M, Adolf C, Quinkler M, Nauck M, Hoffmann W, Rettig R, Hannemann A
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, D-17475, Greifswald, Germany.
Medical Department IV, Klinikum Innenstadt, Ludwig-Maximilians-University Munich, Munich, Germany.
Endocrine. 2017 Aug;57(2):298-307. doi: 10.1007/s12020-017-1348-8. Epub 2017 Jun 22.
Chronic inflammation is an age-independent and body mass index-independent contributor to the development of multi-morbidity. Alterations of the renin-angiotensin-aldosterone system are observed within the context of proinflammatory states. We assessed circulating aldosterone, renin, and inflammatory biomarker concentrations in healthy, normotensive subjects and patients with primary aldosteronism.
We included 1177 normotensive individuals from the population-based Study of Health in Pomerania (first follow-up, Study of Health in Pomerania-1) and 103 primary aldosteronism patients from the German Conn's Registry. A 1:1 matching for sex, age, body mass index, smoking status, diabetes mellitus, and the estimated glomerular filtration rate was performed to determine whether primary aldosteronism patients exhibit higher inflammatory biomarker concentrations than normotensive controls. The associations of plasma aldosterone concentration or plasma renin concentration with circulating fibrinogen concentrations, white blood cell count, and high sensitive C-reactive protein concentrations in the normotensive sample were determined with multivariable linear and logistic regression analyses.
1:1 matched primary aldosteronism patients demonstrated significantly (p < 0.01) higher plasma aldosterone concentration (198 vs. 47 ng/l), lower plasma renin concentration (3.1 vs. 7.7 ng/l) and higher high sensitive C-reactive protein concentrations (1.5 vs. 1.0 mg/l) than normotensive controls. Within the normotensive cohort, plasma renin concentration but not plasma aldosterone concentration was positively associated with fibrinogen concentrations and white blood cell count. Further, a J-shaped association between plasma renin concentration and high sensitive C-reactive protein concentrations was detected.
High plasma aldosterone concentration in a primary aldosteronism cohort and high plasma renin concentration in normotensive subjects are associated with increased concentrations of inflammatory biomarkers. This suggests a link between the renin-angiotensin-aldosterone system and inflammatory processes in patients with primary aldosteronism and even in normotensive subjects.
慢性炎症是一种与年龄和体重指数无关的促成多种疾病发生的因素。在促炎状态下可观察到肾素-血管紧张素-醛固酮系统的改变。我们评估了健康、血压正常的受试者以及原发性醛固酮增多症患者体内循环醛固酮、肾素和炎症生物标志物的浓度。
我们纳入了来自基于人群的波美拉尼亚健康研究（首次随访，波美拉尼亚健康研究-1）的1177名血压正常个体以及来自德国康恩登记处的103名原发性醛固酮增多症患者。进行了性别、年龄、体重指数、吸烟状况、糖尿病和估计肾小球滤过率的1:1匹配，以确定原发性醛固酮增多症患者的炎症生物标志物浓度是否高于血压正常的对照组。在血压正常的样本中，通过多变量线性和逻辑回归分析确定血浆醛固酮浓度或血浆肾素浓度与循环纤维蛋白原浓度、白细胞计数和高敏C反应蛋白浓度之间的关联。
1:1匹配的原发性醛固酮增多症患者与血压正常的对照组相比，血浆醛固酮浓度显著更高（198对47 ng/l，p < 0.01），血浆肾素浓度更低（3.1对7.7 ng/l），高敏C反应蛋白浓度更高（1.5对1.0 mg/l）。在血压正常的队列中，血浆肾素浓度而非血浆醛固酮浓度与纤维蛋白原浓度和白细胞计数呈正相关。此外，还检测到血浆肾素浓度与高敏C反应蛋白浓度之间呈J形关联。
原发性醛固酮增多症队列中的高血浆醛固酮浓度以及血压正常受试者中的高血浆肾素浓度与炎症生物标志物浓度升高有关。这表明在原发性醛固酮增多症患者甚至血压正常的受试者中，肾素-血管紧张素-醛固酮系统与炎症过程之间存在联系。
