Lammintausta R, Erkkola R, Punnonen R, Rauramo L
Ann Clin Res. 1980 Jun;12(3):119-20.
Oestrogens increase plasma renin activity (PRA) by inducing synthesis of renin substrate in the liver. This is proved clinically by the synthetic oestrogens of oral contraceptives and by the equine conjugated oestrogens in postmenopausal therapy. The effect of endogenous oestrogen production on the activity of the renin-aldosterone system is not clear, but progesterone is an important stimulus of renin release in the luteal phase of menstrual cycle. We studied 15 premenopausal women undergoing bilateral oophorectomy. Eight women had high mean serum oestradiol level 1.2 +/- 0.6 (SD) nmol/l for follicular cysts or for a prolonged climacteric proliferation phase. Seven women had normal follicular oestradiol level (0.2 +/- 0.1 nmol/l). In PRA or daily urinary aldosterone excretion (dU-Ald) no differences could be found between the groups. In one month after oophorectomy no changes in PRA or dU-Ald were found in either group, while the serum oestradiol fell to unmeasurable levels. The results suggest that endogenous oestrogens are not to cause activation of the renin-aldosterone axis as measured by the clinically useful PRA and dU-Ald. The result is in agreement with previous reports of postmenopausal therapy with oestriol succinate or oestradiol valerate.
雌激素通过诱导肝脏中肾素底物的合成来增加血浆肾素活性（PRA）。口服避孕药中的合成雌激素以及绝经后治疗中使用的马结合雌激素在临床上证实了这一点。内源性雌激素产生对肾素 - 醛固酮系统活性的影响尚不清楚，但孕酮是月经周期黄体期肾素释放的重要刺激因素。我们研究了15名接受双侧卵巢切除术的绝经前女性。8名女性因卵泡囊肿或更年期增殖期延长，平均血清雌二醇水平较高，为1.2±0.6（标准差）nmol/l。7名女性卵泡期雌二醇水平正常（0.2±0.1 nmol/l）。两组之间在PRA或每日尿醛固酮排泄量（dU - Ald）方面未发现差异。卵巢切除术后一个月，两组的PRA或dU - Ald均未发生变化，而血清雌二醇降至无法测量的水平。结果表明，以内源性雌激素通过临床上有用的PRA和dU - Ald来衡量，其不会导致肾素 - 醛固酮轴的激活。该结果与先前关于琥珀酸雌三醇或戊酸雌二醇绝经后治疗的报道一致。
