Association of renin and aldosterone with glucose metabolism in a Western European population: the KORA F4/FF4 study

Abstract

IntroductionPrimary aldosteronism is associated with impaired glucose tolerance. Whether plasma aldosterone and/or renin concentrations are associated with type 2 diabetes and continuous measures of glucose metabolism in the general population is still under debate.Research design and methodsThe analyses included 2931 participants of the KORA F4 study at baseline and 2010 participants of the KORA FF4 study after a median follow-up of 6.5 years. The associations of active plasma renin and aldosterone concentrations with type 2 diabetes and continuous measures of glucose metabolism were assessed using logistic and linear regression models. Results were adjusted for sex, age, body mass index (BMI), estimated glomerular filtration rate, potassium, use of ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics and calcium channel blockers.ResultsCross-sectionally, renin was associated with type 2 diabetes (OR per SD: 1.25, 95% CI 1.10 to 1.43, p<0.001), fasting glucose, 2-hour glucose, insulin, proinsulin, HOMA-B (homeostasis model assessment of beta cell function) and HOMA-IR (homeostasis model assessment of insulin resistance) (all p values <0.001). Aldosterone was not associated with type 2 diabetes (OR: 1.04, 95% CI 0.91 to 1.19; p=0.547) but with insulin, proinsulin and HOMA-IR (all p values <0.001). The aldosterone–renin ratio was inversely associated with type 2 diabetes and several measures of glucose metabolism. Longitudinally, neither renin (OR: 1.12, 95% CI 0.92 to 1.36) nor aldosterone (OR: 0.91, 95% CI 0.74 to 1.11) were associated with incident type 2 diabetes. Renin was inversely associated with changes of insulin concentrations.ConclusionsIn the KORA F4/FF4 study, renin and aldosterone were not associated with incident type 2 diabetes and largely unrelated to changes of measures of glucose metabolism. Cross-sectionally, aldosterone was associated with surrogate parameters of insulin resistance. However, these associations were not independent of renin.

Exploration of the Shared Genes and Molecular Pathways between Pre-Eclampsia and Type 2 Diabetes Mellitus via Co-Expression Networks Analysis

“…In patients with primary hyperaldosteronism, excessive aldosterone reduces insulin secretion in isolated islets and impairs insulin sensitivity in skeletal muscle and adipocytes [23], leading to a significantly higher risk of T2DM. However, this trend might not be readily transferable to a general population since T2DM cases in a general population are not associated with elevated aldosterone [24]. Normal pregnancy is associated with increased circulating renin, angiotensin II, and aldosterone [25], for an expansion of maternal plasma volume.…”

The Mechanism of Kelulut Honey in Reversing Metabolic Changes in Rats Fed with High-Carbohydrate High-Fat Diet

“…Excessive visceral fat distribution is linked to hypertension by several possible mechanisms involved in hormonal, inflammatory and endothelial alteration [ 50 ]. In an insulin resistant state, the presence of excessive visceral fat can stimulate reabsorption of sodium and urates at the tubular level [ 51 ]. Some studies also consider the possibility of leptin to predict the onset of hypertension [ 52 ].…”

“…A recent study showed that leptin acts on adrenocortical cells to increase CYP11β2 expression and directly activates aldosterone secretion which modulates hypertension in female mice [ 53 , 54 ]. In addition, leptin also elicits symphato-exitatory effects which ensues the activation of RAAS [ 51 ]. A study showed that leptin acts as an autocrine mediator of Ang II-induced cardiomyocyte hypertrophy in hypertensive LVH rats, in which the treatment of telmisartan improves the myocardial remodeling in rats by inhibiting RAAS activity and leptin levels [ 55 ].…”

The Relationship between Renin–Angiotensin–Aldosterone System (RAAS) Activity, Osteoporosis and Estrogen Deficiency in Type 2 Diabetes

“…Hypertension, osteoporosis, adiposity and estrogen deficiency have been identified as risk factors for T2D [193][194][195]. The renin-angiotensin-aldosterone system is positively correlated with T2D and hypertension [196][197][198][199]. Anti-hypertensive medications that block the RAAS have been evidenced to have osteoprotective effects [3,[200][201][202][203][204][205].…”