Plasma renin substrate and oestrogens in normal pregnancy

Immonen, Ilkka; Siimes, Anja; Stenman, Ulf‐Hǎkan; Kärkkäinen, Jorma; Fyhrquist, Frej

doi:10.1080/00365518309168223

Cited by 9 publications

(3 citation statements)

References 11 publications

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“…As shown previously, the renin‐angiotensin‐aldosterone axis is activated during pregnancy (Immonen et al 1983). However, all the measured parameters of the RAS showed either a trend to be lower or were significantly lower in diabetic compared to non‐diabetic women during pregnancy.…”

Section: Discussionsupporting

confidence: 59%

Vasoactive mediators and retinopathy during type 1 diabetic pregnancy

Loukovaara

Immonen

Yandle

et al. 2005

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To evaluate the role of various vasoactive hormones in the evolution of diabetic retinopathy during pregnancy and postpartum. Methods: Retinopathy was graded from fundus photographs of 45 pregnant women with type 1 diabetes and seven pregnant women without diabetes in a prospective study. Markers of renin-angiotensin-system (RAS), plasma renin activity (PRA), angiotensin II (AngII), aldosterone, natriuretic peptides (ANP, BNP, CNP) and adreonomedullin (AM) were measured during the first and third trimesters and at 3 months postpartum. The women with diabetes were grouped by progression of retinopathy during pregnancy and postpartum. Results: Levels of PRA (p ¼ 0.001) and ANP (p ¼ 0.03) were significantly lower in diabetes than in non-diabetes subjects throughout pregnancy and postpartum. No significant differences appeared in levels of AngII, aldosterone, AM, BNP or CNP between the two groups. In multivariate logistic regression analyses with retinopathy progression by the third trimester as the dependent variable, only duration of diabetes qualified in the model (p ¼ 0.027, R ¼ 0.227, Exp(B) ¼ 1.28). Conclusions: Diabetic pregnancy is associated with lower levels of PRA and ANP compared to non-diabetic pregnancy. Lowered RAS activity may contribute to the hyperdynamic blood flow and progression of DR during diabetic pregnancy. Within the power of this study no clear associations between the vasoactive hormones and progression of retinopathy could be detected.

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Section: Discussionsupporting

confidence: 59%

Vasoactive mediators and retinopathy during type 1 diabetic pregnancy

Loukovaara

Immonen

Yandle

et al. 2005

Acta Ophthalmologica Scandinavica

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“…; Immonen et al . ; Krattenmacher et al . ), while Asian women have higher levels of oestrogen during pregnancy compared with Caucasian women.…”

Section: Discussionmentioning

confidence: 99%

Asian women have attenuated sympathetic activation but enhanced renal–adrenal responses during pregnancy compared to Caucasian women

Okada

Best

Jarvis

et al. 2015

The Journal of Physiology

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Key pointsr Asian women have a lower prevalence of hypertensive disorders of pregnancy than Caucasian women.r This is the first longitudinal study to investigate neural and humoral responses during pregnancy in Asians and Caucasians.r The key finding was that Asians had attenuated sympathetic activation but enhanced renal-adrenal responsiveness during pregnancy compared to Caucasians.r These results may provide insights into the pathophysiological mechanisms for racial differences in the prevalence of hypertensive disorders during pregnancy.Abstract Asians have a lower prevalence of hypertensive disorders of pregnancy than Caucasians. Since sympathetic overactivity and dysregulation of the renal-adrenal system (e.g. low aldosterone levels) have been found in preeclamptic women, we hypothesized that Asians have lower muscle sympathetic nerve activity (MSNA) and greater aldosterone concentrations during normal pregnancy than Caucasians. In a prospective study, blood pressure (BP), heart rate (HR), and MSNA were measured during supine and upright tilt (30 deg and 60 deg for 5 min each) in 9 Asians (32 ± 1 years (mean ± SEM)) and 12 Caucasians (29 ± 1 years) during pre-, early (ࣘ8 weeks of gestation) and late (32-36 weeks) pregnancy, and post-partum (6-10 weeks after delivery). Supine MSNA increased with pregnancy in both groups (P < 0.001); it was significantly lower in Asians than Caucasians (14 ± 3 vs. 23 ± 3 bursts min −1 and 16 ± 5 vs. 30 ± 3 bursts min −1 in early and late pregnancy, respectively; P = 0.023). BP decreased during early pregnancy (P < 0.001), but was restored during late pregnancy. HR increased during pregnancy (P < 0.001) with no racial difference (P = 0.758). MSNA increased during tilting and it was markedly lower in Asians than Caucasians in late pregnancy (31 ± 6 vs. 49 ± 3 bursts min −1 at 60 deg tilt; P = 0.003). Upright BP was lower in Asians, even in pre-pregnancy (P = 0.006), and this racial difference persisted during pregnancy. Direct renin and aldosterone increased during pregnancy (both P < 0.001); these hormones were greater in Asians (P = 0.086 and P = 0.014). Thus, Asians have less sympathetic activation but more upregulated renal-adrenal responses than Caucasians during pregnancy. These results may explain, at least in part, why Asian women are at low risk of hypertensive disorders in pregnancy.

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“…This involves a rise in renin from the kidneys which is related to the fall in systemic vascular tone. A concurrent rise in circulating angiotensinogen occurs, due to the stimulation of hepatic angiotensinogen synthesis by estrogen (Immonen, et al 1983). Together renin and angiotensinogen generate angiotensin (Ang) I, which is subsequently converted to the active end-product of the cascade, Ang II, by angiotensinconverting enzyme (ACE).…”

Section: Introductionmentioning

confidence: 99%

First-trimester maternal renin–angiotensin–aldosterone system activation and fetal growth and birthweight: the Rotterdam Periconceptional Cohort

Wiegel

Fares

Willemsen

et al. 2022

Reproductive BioMedicine Online

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Research question: Does first-trimester maternal renin-angiotensin-aldosterone system (RAAS) activity determine early and late fetal growth and birth weight? Design: A total of 201 ongoing pregnancies, of which 119 conceived spontaneously and 82 after in-vitro fertilization or intracytoplasmic sperm injection treatment were selected from the Rotterdam Periconceptional Cohort. Renin, prorenin and aldosterone concentrations were determined in blood plasma at 9 and 11 weeks gestational age (GA). Serial crown-rump length and embryonic volume at 7, 9 and 11 weeks GA were measured using Virtual Reality software to assess early fetal growth. Estimated fetal weight at 22 and 32 weeks GA and birth weight were measured to assess late fetal growth trajectories. Pregnancy outcomes; SGA (1 CL versus pregnancies with 1 CL (beta z-scores : -0.17, 95%CI: -0.32, -0.01, P=0.04). Wiegel et al. 2021Conclusion: This study shows that excessive first-trimester prorenin release, resulting in angiotensin upregulation, can explain why pregnancies with >1 CL are at risk for offspring with decreased birth weight and SGA. Simultaneously, high concentrations of aldosterone, independent of renin, seem to have a beneficial influence.

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Plasma renin substrate and oestrogens in normal pregnancy

Cited by 9 publications

References 11 publications

Vasoactive mediators and retinopathy during type 1 diabetic pregnancy

Vasoactive mediators and retinopathy during type 1 diabetic pregnancy

Asian women have attenuated sympathetic activation but enhanced renal–adrenal responses during pregnancy compared to Caucasian women

First-trimester maternal renin–angiotensin–aldosterone system activation and fetal growth and birthweight: the Rotterdam Periconceptional Cohort

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