Beretta-Piccoli C, Weidmann P, Bianchetti M G, Brown J J, Fraser R, Lever A F, Link L, Robertson J I
Clin Exp Hypertens A. 1982;4(9-10):1541-58. doi: 10.3109/10641968209061624.
The effects of standard oral glucose loading (100 g) on plasma aldosterone and some regulatory factors were assessed in patients with primary hyperaldosteronism and normal subjects. Following overnight fast, mean plasma glucose was identical (10 patients and normal subjects approximately matched per age and sex); plasma insulin, potassium and renin levels were lower and plasma aldosterone higher in the patients. Glucose loading significantly increased plasma glucose and insulin concentrations and decreased plasma potassium and aldosterone levels in both groups; plasma renin activity was significantly increased only in normal subjects. The increases in plasma insulin and the decreases in plasma potassium or aldosterone tended to be blunted in primary hyperaldosteronism. Relationships among glucose-induced changes in plasma aldosterone and other factors were assessed by multiple regression analysis in these patients and normal subjects as well as an additional group of 21 normal subjects; in the latter, plasma cortisol was also measured and found to decrease significantly after glucose loading. Changes in plasma aldosterone correlated (P less than 0.025) more closely with those in plasma potassium in the patients and with variations in plasma renin activity in the normal subjects. These findings suggest that complex metabolic changes occur following glucose ingestion which are capable of modifying aldosterone secretion in normal subjects and primary hyperaldosteronism. The aldosterone-inhibitory effect of glucose tends to be blunted in the latter disorder. This could be related at least in part to an impaired insulin response in primary hyperaldosteronism.
在原发性醛固酮增多症患者和正常受试者中评估了标准口服葡萄糖负荷（100克）对血浆醛固酮及一些调节因子的影响。经过一夜禁食后，两组的平均血浆葡萄糖水平相同（按年龄和性别大致匹配的10名患者和正常受试者）；患者的血浆胰岛素、钾和肾素水平较低，血浆醛固酮水平较高。葡萄糖负荷使两组的血浆葡萄糖和胰岛素浓度显著升高，血浆钾和醛固酮水平降低；仅正常受试者的血浆肾素活性显著升高。在原发性醛固酮增多症患者中，血浆胰岛素的升高以及血浆钾或醛固酮的降低往往减弱。通过多元回归分析评估了这些患者和正常受试者以及另外一组21名正常受试者中葡萄糖诱导的血浆醛固酮变化与其他因素之间的关系；在后者中，还测量了血浆皮质醇，发现葡萄糖负荷后其显著降低。在患者中，血浆醛固酮的变化与血浆钾的变化相关性更强（P小于0.025），在正常受试者中与血浆肾素活性的变化相关。这些发现表明，摄入葡萄糖后会发生复杂的代谢变化，这些变化能够改变正常受试者和原发性醛固酮增多症患者的醛固酮分泌。在后者这种疾病中，葡萄糖的醛固酮抑制作用往往减弱。这可能至少部分与原发性醛固酮增多症中胰岛素反应受损有关。
