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Effects of standard oral glucose loading on the renin-angiotensin-aldosterone system and its relationship to circulating insulin

Wirkungen einer oralen Standard-Glukosebelastung auf das Renin-Angiotensin-Aldosteron-System und dessen Beziehung zum zirkulierenden Insulin

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Zusammenfassung

Der Einfluß einer oralen Standard-Glukosebelastung (100 g) auf die Plasma-Konzentrationen von Glukose, Insulin, Kalium, Renin und Aldosteron wurde bei 10 liegenden Normalpersonen untersucht (Gruppe A). Das Verhalten der Plasma-Konzentrationen von Glukose, Insulin, Kalium und Aldosteron nach einer solchen Glukose-Einnahme wurde zudem bei 16 sitzenden, normalen oder grenzwertig-hypertensiven Personen studiert (Gruppe B), wobei die Untersuchungen im unbehandelten Zustand sowie nach Aktivierung des Renin-Aldosteron-Systems durch Vorbehandlung mit Diuretika erfolgten. In beiden Gruppen wurde der Anstieg der Plasma-Glukose und -Insulinwerte nach Glukose-einnahme von einer akuten Senkung (p<0,01) der Plasma-Kalium und -Aldosteron-Konzentrationen begleitet. In Gruppe A fand sich gleichzeitig ein signifikanter Anstieg (p<0,02) der Plasma-Renin-Aktivität. Die gemeinsame Analyse aller Personen ergab signifikante (p<0,005) Korrelationen zwischen den basalen (prä-Glukose-Infusion) Absolutwerten von Plasma-Aldosteron und -Kalium einerseits und zwischen den Glukose-induzierten Änderungen dieser beiden Parameter andererseits. In Gruppe A fanden sich zudem nach der Glukose-Einnahme signifikante Beziehungen zwischen den absoluten Plasma-Aldosteron und-Reninwerten, sowie zwischen den Änderungen dieser beiden Parameter (p<0,001). Dagegen korrelierten Plasma-Aldosteron- oder -Reninspiegel nicht signifikant mit den Glukose- oder Insulinwerten. Diese Befunde zeigen, daß eine orale Standard-Zufuhr von Glukose akut eine markante Aldosteron-Hemmung und eine leichte, aber signifikante Renin-Stimulation bewirkt. Die Glukose-induzierte Aldosteron-Suppression scheint mit den Insulin-vermittelten Änderungen des Kaliummetabolismus in Zusammenhang zu stehen und durch die Renin-Aktivierung teilweise antagonisiert zu werden.

Summary

The effects of a standard oral glucose load (100 g) on plasma glucose, insulin, potassium, renin and aldosterone levels were investigated in 10 supine normal subjects (Group A). Responses of plasma glucose, insulin, potassium and aldosterone to glucose ingestion were evaluated further in 16 seated normal or borderline hypertensive subjects (Group B), studied in the untreated state as well as following renin-aldosterone activation by diuretic pre-treatment. In both groups, the increase in plasma glucose and insulin following glucose ingestion was accompanied by an acute decrease (p<0.01) in plasma potassium and aldosterone levels, which in Group A was associated with an increase (p<0.02) in plasma renin activity. In all subjects analyzed together, significant (p<0.005) correlations were noted between plasma aldosterone and potassium levels and between glucose-induced changes in these factors. In Group A, there were significant (p<0.001) correlations between glucose-induced changes in plasma aldosterone and renin values and between absolute aldosterone and renin levels in the glucose-loaded state. Plasma aldosterone or renin levels following glucose-load were unrelated to glucose or insulin values. These findings indicate that an oral standard glucose load causes acutely marked aldosterone suppression and mild but distinct renin stimulation. The glucose-induced inhibition of aldosterone secretion appears to depend on insulin-mediated changes in potassium metabolism and may be partly counteracted by concomitant renin activation.

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Authors and Affiliations

  1. Medizinische Poliklinik and Department of Clinical Chemistry, University of Berne, Switzerland

    C. Beretta-Piccoli,  P. Weidmann, J. Flammer, Z. Glück & C. Bachmann

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  1. C. Beretta-Piccoli
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  2. P. Weidmann
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  3. J. Flammer
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  4. Z. Glück
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  5. C. Bachmann
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Supported by the Swiss National Science Foundation

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Beretta-Piccoli, C., Weidmann, P., Flammer, J. et al. Effects of standard oral glucose loading on the renin-angiotensin-aldosterone system and its relationship to circulating insulin. Klin Wochenschr 58, 467–474 (1980). https://doi.org/10.1007/BF01476801

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  • DOI: https://doi.org/10.1007/BF01476801

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