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Associations of aldosterone and renin concentrations with inflammation—the Study of Health in Pomerania and the German Conn’s Registry

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Abstract

Purpose

Chronic inflammation is an age-independent and body mass index-independent contributor to the development of multi-morbidity. Alterations of the renin-angiotensin-aldosterone system are observed within the context of proinflammatory states. We assessed circulating aldosterone, renin, and inflammatory biomarker concentrations in healthy, normotensive subjects and patients with primary aldosteronism.

Methods

We included 1177 normotensive individuals from the population-based Study of Health in Pomerania (first follow-up, Study of Health in Pomerania-1) and 103 primary aldosteronism patients from the German Conn’s Registry. A 1:1 matching for sex, age, body mass index, smoking status, diabetes mellitus, and the estimated glomerular filtration rate was performed to determine whether primary aldosteronism patients exhibit higher inflammatory biomarker concentrations than normotensive controls. The associations of plasma aldosterone concentration or plasma renin concentration with circulating fibrinogen concentrations, white blood cell count, and high sensitive C-reactive protein concentrations in the normotensive sample were determined with multivariable linear and logistic regression analyses.

Results

1:1 matched primary aldosteronism patients demonstrated significantly (p < 0.01) higher plasma aldosterone concentration (198 vs. 47 ng/l), lower plasma renin concentration (3.1 vs. 7.7 ng/l) and higher high sensitive C-reactive protein concentrations (1.5 vs. 1.0 mg/l) than normotensive controls. Within the normotensive cohort, plasma renin concentration but not plasma aldosterone concentration was positively associated with fibrinogen concentrations and white blood cell count. Further, a J-shaped association between plasma renin concentration and high sensitive C-reactive protein concentrations was detected.

Conclusions

High plasma aldosterone concentration in a primary aldosteronism cohort and high plasma renin concentration in normotensive subjects are associated with increased concentrations of inflammatory biomarkers. This suggests a link between the renin-angiotensin-aldosterone system and inflammatory processes in patients with primary aldosteronism and even in normotensive subjects.

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Funding

SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grants no. 01ZZ9603, 01ZZ0103, and 01ZZ0403), the Ministry of Cultural Affairs, as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania. Instand e.V. provided partial grant support for the determination of plasma samples in SHIP. The German Conn-Registry is supported by the Else Kröner–Fresenius Stiftung (Grant No. 2015_A171 to M.R).

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Authors and Affiliations

  1. Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, D-17475, Greifswald, Germany

    A. Grotevendt, H. Wallaschofski, M. Nauck & A. Hannemann

  2. Medical Department IV, Klinikum Innenstadt, Ludwig-Maximilians-University Munich, Munich, Germany

    M. Reincke & C. Adolf

  3. Endocrinology in Charlottenburg, Berlin, Germany

    M. Quinkler

  4. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

    W. Hoffmann

  5. Institute of Physiology, University Medicine Greifswald, Greifswald, Germany

    R. Rettig

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  1. A. Grotevendt
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  2. H. Wallaschofski
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  3. M. Reincke
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  4. C. Adolf
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  9. A. Hannemann
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Correspondence to A. Hannemann.

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Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical approval

All procedures performed in SHIP or the German Conn’s Registry involving human participants were in accordance with the standards of the Ethics Committee of the Board of Physicians Mecklenburg-West Pomerania at the University of Greifswald (SHIP) or the ethics committees of the respective participating centers (German Conn’s Registry) and conformed to the principles of the Declaration of Helsinki. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the SHIP study and the German Conn’s Registry.

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Grotevendt, A., Wallaschofski, H., Reincke, M. et al. Associations of aldosterone and renin concentrations with inflammation—the Study of Health in Pomerania and the German Conn’s Registry. Endocrine 57, 298–307 (2017). https://doi.org/10.1007/s12020-017-1348-8

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  • DOI: https://doi.org/10.1007/s12020-017-1348-8

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