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亚诺马米印第安人的血清醛固酮与蛋白质结合变量:与部分文化适应的瓜伊米印第安人相比的无盐文化情况

Serum aldosterone and protein-binding variables in Yanomama Indians: a no-salt culture as compared to partially acculturated Guaymi Indians.

作者信息

Nowaczynski W, Oliver W J, Neel J V

出版信息

Clin Physiol Biochem. 1985;3(6):289-306.

PMID:3907928
Abstract

Yanomama Indians from the jungles of southern Venezuela and northern Brazil excreted 1 +/- 1.5 mEq of Na and 203 +/- 109 mEq of K and had low blood pressure (BP), 102/62 mm Hg). In comparison, Guaymi Indians of Panama excreted 103 +/- 50 mEq of Na and 118 +/- 52 mEq of K and had significantly higher BP (114/75 mm Hg, p less than 0.001). Elucidating the renin-aldosterone axis, total upright serum aldosterone in 34 Yanomama was high (85.6 +/- 78 ng/100 ml). The binding capacities of thermolabile (ABG) and thermostable (ABG-Ts) serum globulins for aldosterone were elevated at 23.8 +/- 6 and 14.9 +/- 2.6%, respectively; consequently, total ABG- plus ABG-Ts- bound aldosterone was as high as 38.6 +/- 6.3%. Plasma renin activity (PRA 10.3 +/- 2.4 ng/ml/h) and urinary aldosterone 18-glucuronide (70.3 +/- 30 micrograms/24 h) in 17 Yanomama were also very high. In contrast, total serum corticosteroids and corticosteroid-binding globulin (CBG) binding capacity were normal, suggesting normal ACTH activity. PRA correlated positively with total (r = 0.47, p less than 0.05) and free (r = 0.47, p less than 0.05) serum aldosterone, which in turn showed a negative trend with Na (r = 0.33, NS) excretion. The effect of high dietary K appeared less important to aldosterone stimulation and PRA suppression. ABG-bound aldosterone (r = 0.43, p less than 0.01) as well as ABG-Ts (r = 0.56, p less than 0.05) were negatively correlated with diastolic but not systolic BP. The total ABG- and ABG-Ts-bound fraction correlated with diastolic BP (r = 0.43, p less than 0.05) in contrast to the free fraction (r = 0.08, NS) or total aldosterone (r = -0.09). Apparently, only bound serum aldosterone is important for the maintenance of diastolic BP. High serum aldosterone, with elevated excretion, indicates an increased secretion rate; increased serum protein binding suggests an increased tissular activity and alterations in aldosterone metabolism. In Guaymi Indians both total plasma aldosterone (14.5 +/- 65 ng/100 ml) and urinary aldosterone (8.1 +/- 4.8 micrograms/creatinine excretion) were normal. ABG-binding capacity for aldosterone was moderately elevated (17.8 +/- 4.8) and of ABG-Ts normal (10.2 +/- 1.2) suggesting a nearly normal aldosterone metabolism and regulation. The BP of Guaymi was significantly higher than that of the Yanomama.

摘要

来自委内瑞拉南部和巴西北部丛林的亚诺玛米印第安人,钠排泄量为1±1.5毫当量,钾排泄量为203±109毫当量,血压较低(102/62毫米汞柱)。相比之下,巴拿马的圭米印第安人钠排泄量为103±50毫当量,钾排泄量为118±52毫当量,血压显著较高(114/75毫米汞柱,p<0.001)。在阐明肾素 - 醛固酮轴方面,34名亚诺玛米人的总直立血清醛固酮水平较高(85.6±78纳克/100毫升)。热不稳定血清球蛋白(ABG)和热稳定血清球蛋白(ABG - Ts)对醛固酮的结合能力分别升高了23.8±6%和14.9±2.6%;因此,ABG加ABG - Ts结合的醛固酮总量高达38.6±6.3%。17名亚诺玛米人的血浆肾素活性(PRA 10.3±2.4纳克/毫升/小时)和尿醛固酮18 - 葡萄糖醛酸苷(70.3±30微克/24小时)也非常高。相比之下,总血清皮质类固醇和皮质类固醇结合球蛋白(CBG)结合能力正常,表明促肾上腺皮质激素(ACTH)活性正常。PRA与总血清醛固酮(r = 0.47,p<0.05)和游离血清醛固酮(r = 0.47,p<0.05)呈正相关,而血清醛固酮又与钠排泄量呈负相关趋势(r = 0.33,无统计学意义)。高膳食钾对醛固酮刺激和PRA抑制的影响似乎不太重要。ABG结合的醛固酮(r = 0.43,p<0.01)以及ABG - Ts(r = 0.56,p<0.05)与舒张压而非收缩压呈负相关。ABG和ABG - Ts结合的总分数与舒张压相关(r = 0.43,p<0.05),而游离分数(r = 0.08,无统计学意义)或总醛固酮(r = -0.09)则不然。显然,只有结合的血清醛固酮对维持舒张压很重要。高血清醛固酮且排泄量增加表明分泌率增加;血清蛋白结合增加表明组织活性增加以及醛固酮代谢改变。在圭米印第安人中,总血浆醛固酮(14.5±65纳克/100毫升)和尿醛固酮(8.1±4.8微克/肌酐排泄量)均正常。ABG对醛固酮的结合能力适度升高(17.8±4.8),ABG - Ts正常(10.2±1.2),表明醛固酮代谢和调节近乎正常。圭米人的血压显著高于亚诺玛米人。

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