Association of angiotensin-II levels with albuminuria in subjects with normal glucose metabolism, prediabetes, and type 2 diabetes mellitus

作者：Min Se Hee; Kong Sung Hye; Lee Jie Eun; Lee Dong Hwa; Oh Tae Jung; Kim Kyoung Min; Park Kyong Soo; Jang Hak Chul; Lim Soo^*

来源：Journal of Diabetes and Its Complications, 2017, 31(10): 1499-1505.

DOI：10.1016/j.jdiacomp.2017.07.002

• Angiotensin-II
• albuminuria
• type 2 diabetes
• RAS
• Microvascular complications

Objectives: The relationship between the renin-angiotensin system (RAS) and diabetes has been studied for many years. However, studies that assessed RAS components comprehensively were limited. We hypothesized that serum RAS components, especially the effector peptide angiotensin-II, might be closely associated with glucose metabolism status and diabetic complications.
Methods: We investigated the association of individual RAS component with albuminuria in 407 subjects with normal glucose metabolism (NGM), prediabetes, or type 2 diabetes mellitus (T2DM). Anthropometric and biochemical parameters, including glucose homeostasis, albuminuria, and RAS-related parameters such as plasma renin activity (PRA), aldosterone, angiotensin-converting enzyme (ACE), and angiotensin-II levels, were measured.
Results: The mean standard deviation (SD) age and body mass index were 57.1 +/- 11.1 years and 24.7 +/- 3.3 kg/m(2), respectively. There were 54 subjects with NGM, 102 with prediabetes, and 251 with T2DM. The mean SD angiotensin-II levels in these groups were 9.32 +/- 6.89, 12.89 +/- 10.39, and 17.00 +/- 15.28 pg/mL, and the respective urinary albumin-to-creatinine ratios (ACRs) were 8.1 +/- 5.3, 133 +/- 17.3, and 30.7 +/- 51.9 mg/g, which were significantly different among the groups. The serum angiotensin-II levels were correlated with levels of PRA, insulin resistance, C-reactive protein, and urinary ACR. Among RAS-related parameters, only the angiotensin-II level was significantly associated with urinary ACR after adjusting for relevant risk factors.
Conclusions: Angiotensin-II may play an important role in the development of albuminuria, particularly in subjects with impaired glucose metabolism.

• 出版日期2017-10