ISSN:
1432-0428
Keywords:
Type 1 (insulin-dependent) diabetes mellitus
;
renin activity
;
angiotensin II
;
aldosterone
;
adrenaline
;
nor-adrenaline
;
catecholamines
;
sympathetic nerve function
;
autonomic neuropathy
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary To evaluate the renin-angiotensin-aldosterone system in relation to circulatory catecholamines, we determined renin activity, angiotensin II, aldosterone, adrenaline, and noradrenaline in plasma before and during a submaximal bicycle exercise test in 23 Type 1 (insulin-dependent) diabetic patients (aged 19–57 years, mean 37; duration of diabetes 2–32 years, mean 16), 17 with signs of cardiac autonomic neuropathy, and in 18 healthy non-diabetic subjects (aged 24–41 years, mean 29). At rest, Type 1 diabetic patients showed significantly lower aldosterone values than control subjects (0.14±0.02 nmol/l and 0.22±0.02 nmol/l; p〈0.01) while renin activity (1.0±0.1 nmol·l−1·h−1 and 0.9±0.1 nmol·l−1·h−1) and angiotensin II (14±1 nmol/l and 18±2 nmol/l) did not differ significantly between patients and control subjects. During exercise, increments (increase from the resting value to the value at 80% of maximal working capacity) in renin (1.5±0.4 nmol·l−1·h−1 and 3.7±0.5 nmol·l−1 ·h−1; p〈0.001), angiotensin II (28±8 nmol/l and 60±8 nmol/l; p〈0.01), aldosterone (0.16±0.04 nmol/l and 0.25±0.05 nmol/l; p〈0.05), adrenaline (1.96±0.49 nmol/l and 2.92±0.51 nmol/l; ps〈0.05), and noradrenaline (12.01±1.25 nmol/l and 18.74±1.45 nmol/l; p〈0.01) were significantly lower in the patients than in control subjects. There was no difference in the renin-angiotensin-aldosterone response to exercise between patients with and without cardiac autonomic neuropathy but the impaired catecholamine reaction was confined to patients with cardiac autonomic neuropathy. In conclusion, Type 1 diabetic patients demonstrated low resting plasma aldosterone and reduced increments in renin activity, angiotensin II, aldosterone, and catecholamines during exercise. The low aldosterone values might be related to dysfunction of adrenal zona glomerulosa cells while it is unlikely that the reduced response to exercise of the renin-angiotensin-aldosterone system simply reflects sympathetic nerve failure.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00404041
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