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Atherosclerosis. 2016 Sep;252:88-96. doi: 10.1016/j.atherosclerosis.2016.07.905. Epub 2016 Jul 17.

Altered relation of the renin-aldosterone system and vasoactive peptides in type 2 diabetes: The KORA F4 study.

Author information

1
Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany. Electronic address: cornelia.then@med.uni-muenchen.de.
2
Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
3
Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany.
4
Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
5
Department of Internal Medicine II - Cardiology, University of Ulm, Medical Centre, Ulm, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
6
Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Research Unit of Molecular Epidemiology, German Research Center for Environmental Health, Neuherberg, Germany.
7
German Diabetes Center, Leibniz Institute at Heinrich Heine University Düsseldorf, Institute of Biometrics and Epidemiology, Düsseldorf, Germany.

Abstract

BACKGROUND AND AIMS:

The exact mechanism of premature atherosclerosis in diabetes is still unclear. Inappropriate activation of the renin-aldosterone-angiotensin system may be an important risk factor for cardiovascular disease. We investigated whether renin and aldosterone are associated with vasoactive peptides midregional-pro atrial natriuretic peptide (MR-proANP) and midregional-pro adrenomedullin (MR-proADM), or with intima media thickness (IMT) as a marker for early atherosclerotic alterations in the general community and in subjects with type 2 diabetes.

METHODS:

In 1261 participants in the KORA F4 study, the associations of renin, aldosterone and aldosterone to renin ratio with MR-proANP, MR-proADM and IMT were assessed using linear regression models stratified for the presence of prediabetes and type 2 diabetes.

RESULTS:

After adjustment for confounding factors, an inverse association of MR-proANP with renin (p = 0.002) and aldosterone (p = 0.021) and a direct association of MR-proADM with renin (p < 0.001) and aldosterone (p = 0.019) were seen in nondiabetic individuals. In diabetic subjects, there was no significant correlation of MR-proANP or MR-proADM with renin or aldosterone. Renin and aldosterone were not directly associated with IMT in non-diabetic subjects and the total cohort, whereas aldosterone was associated with IMT in diabetic participants (p = 0.005).

CONCLUSIONS:

This study shows associations between renin, aldosterone and MR-proANP/MR-proADM plasma levels that are altered in type 2 diabetes. Plasma renin and aldosterone are not independent biomarkers for early atherosclerotic damages of the carotid arteries in the general community.

KEYWORDS:

ANP; Adrenomedullin; Aldosterone; Diabetes; MR-proADM; MR-proANP; Renin

[Indexed for MEDLINE]

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