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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenomedullin / blood
  • Adult
  • Aged
  • Aldosterone / blood*
  • Anthropometry
  • Biomarkers / blood
  • Carotid Arteries / pathology
  • Carotid Intima-Media Thickness*
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Disease Progression
  • Female
  • Glucose Tolerance Test
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Peptide Fragments / chemistry*
  • Prediabetic State / blood*
  • Protein Precursors / blood
  • Renin / blood*
  • Risk Factors

Substances

  • Biomarkers
  • Peptide Fragments
  • Protein Precursors
  • Adrenomedullin
  • Aldosterone
  • Renin