Williams G H, Cain J P, Dluhy R G, Underwood R H
J Clin Invest. 1972 Jul;51(7):1731-42. doi: 10.1172/JCI106974.
The peripheral plasma levels of aldosterone, renin activity (PRA), potassium, corticosterone, cortisol, and in some cases angiotensin II, were measured in normal subjects undergoing postural changes, acute diuretic-induced volume depletion, and alterations in dietary sodium. On a 10 mEq sodium/100 mEq potassium intake, subjects supine for 3 consecutive days had identical diurnal patterns of PRA, angiotensin II, aldosterone, cortisol, and corticosterone, with peaks at 8 a.m. and nadirs at 11 p.m. With an increase in sodium intake to 200 mEq, plasma levels of aldosterone and PRA fell to one-third their previous levels but the diurnal pattern in supine subjects was unchanged and again parallel to that of cortisol and corticosterone. There was no diurnal variation of plasma potassium on either sodium intake in the supine subjects. On a 10 mEq sodium/100 mEq potassium intake, supine 8 a.m. plasma aldosterone (55+/-7 ng/100 ml) and PRA (886+/-121 ng/100 ml per 3 hr) increased by 150-200% after subjects were upright for 3 hr. However, even though the patients maintained an upright activity pattern, there was a significant fall in plasma aldosterone to 33+/-5 ng/100 ml at 11 p.m. Potassium levels varied in a fashion parallel to aldosterone and PRA. Plasma cortisol and corticosterone had a diurnal pattern similar to that found in supine subjects. In response to acute diuretic-induced volume depletion, the nocturnal fall in aldosterone levels did not occur. The 11 p.m. value (102+/-20 ng/100 ml) and the 8 a.m. value postdiuresis (86+/-15 ng/100 ml) were both significantly greater than the prediuresis levels. PRA showed a similar altered pattern while potassium levels fell throughout the day. In some but not all studies, changes in plasma aldosterone coincided with changes in plasma cortisol, corticosterone, and/or potassium. However, in all studies, changes in plasma aldosterone were invariably associated with parallel changes in plasma renin activity and/or angiotensin II levels. These findings support the concept that PRA is the dominant factor in the control of aldosterone when volume and/or dietary sodium is altered in normal man.
在经历体位改变、急性利尿剂诱导的容量耗竭以及饮食钠含量改变的正常受试者中，测量了醛固酮、肾素活性（PRA）、钾、皮质酮、皮质醇，在某些情况下还测量了血管紧张素II的外周血浆水平。在摄入10 mEq钠/100 mEq钾的情况下，连续3天仰卧的受试者的PRA、血管紧张素II、醛固酮、皮质醇和皮质酮具有相同的昼夜模式，上午8点达到峰值，晚上11点达到最低点。随着钠摄入量增加到200 mEq，醛固酮和PRA的血浆水平降至先前水平的三分之一，但仰卧受试者的昼夜模式未改变，且再次与皮质醇和皮质酮的模式平行。仰卧受试者在两种钠摄入量下血浆钾均无昼夜变化。在摄入10 mEq钠/100 mEq钾的情况下，上午8点仰卧时血浆醛固酮（55±7 ng/100 ml）和PRA（886±121 ng/100 ml每3小时）在受试者直立3小时后增加150 - 200%。然而，即使患者保持直立活动模式，晚上11点时血浆醛固酮仍显著降至33±5 ng/100 ml。钾水平的变化与醛固酮和PRA的变化趋势平行。血浆皮质醇和皮质酮的昼夜模式与仰卧受试者相似。对急性利尿剂诱导的容量耗竭的反应中，醛固酮水平的夜间下降未出现。晚上11点的值（102±20 ng/100 ml）和利尿后上午8点的值（86±15 ng/100 ml）均显著高于利尿前水平。PRA呈现类似的改变模式，而钾水平全天下降。在一些但并非所有研究中，血浆醛固酮的变化与血浆皮质醇、皮质酮和/或钾的变化一致。然而，在所有研究中，血浆醛固酮的变化总是与血浆肾素活性和/或血管紧张素II水平的平行变化相关。这些发现支持了这样一种概念，即在正常人体内，当容量和/或饮食钠发生改变时，PRA是控制醛固酮的主导因素。
