Naruse M, Wasada T, Naruse K, Yoshimoto T, Omori Y, Demura H
Department of Medicine, Tokyo Women's Medical College, Japan.
Endocr J. 1995 Apr;42(2):225-33. doi: 10.1507/endocrj.42.225.
To seek the pathophysiologic significance of measuring the concentration of total renin instead of prorenin, we determined the plasma total renin concentration by immunoradiometric assay and correlated the results with various clinical features and laboratory parameters of diabetic complication in 108 patients with diabetes mellitus. The plasma prorenin concentration was estimated as the difference between the total and active renin concentrations. The plasma total renin and prorenin concentrations were high in patients with diabetes mellitus, in contrast to the active renin concentration which was slightly decreased. In addition, the plasma total renin and prorenin concentrations were higher in patients with diabetic complications than in patients without any complication. Multiple regression analysis showed that the presence of orthostatic hypotension, diabetic retinopathy, and proteinuria is significantly associated with the increased plasma total renin and prorenin concentrations. In addition, there was a significant positive correlation between the total renin and prorenin concentrations. These results suggest that both the plasma total renin concentration and the prorenin concentration are closely related to diabetic complications. Determination of the plasma total renin concentration by immunoradiometric assay as a substitute for prorenin could be a powerful tool in elucidating the mechanism for the increased plasma prorenin in diabetes mellitus.
为探究测定总肾素而非肾素原浓度的病理生理意义，我们采用免疫放射分析法测定了108例糖尿病患者的血浆总肾素浓度，并将结果与糖尿病并发症的各种临床特征和实验室参数进行关联分析。血浆肾素原浓度通过总肾素浓度与活性肾素浓度之差来估算。糖尿病患者的血浆总肾素和肾素原浓度较高，而活性肾素浓度略有下降。此外，有糖尿病并发症的患者血浆总肾素和肾素原浓度高于无任何并发症的患者。多元回归分析表明，体位性低血压、糖尿病视网膜病变和蛋白尿的存在与血浆总肾素和肾素原浓度升高显著相关。此外，总肾素和肾素原浓度之间存在显著正相关。这些结果提示，血浆总肾素浓度和肾素原浓度均与糖尿病并发症密切相关。采用免疫放射分析法测定血浆总肾素浓度以替代肾素原，可能是阐明糖尿病患者血浆肾素原升高机制的有力工具。
