title: Altered relation of the renin-aldosterone system and vasoactive peptides in type 2 diabetes: The KORA F4 study.
abstract: The exact mechanism of premature atherosclerosis in diabetes is still unclear. Inappropriate activation of the renin-aldosterone-angiotensin system may be an important risk factor for cardiovascular disease. We investigated whether renin and aldosterone are associated with vasoactive peptides midregional-pro atrial natriuretic peptide (MR-proANP) and midregional-pro adrenomedullin (MR-proADM), or with intima media thickness (IMT) as a marker for early atherosclerotic alterations in the general community and in subjects with type 2 diabetes.
  
  
  
  In 1261 participants in the KORA F4 study, the associations of renin, aldosterone and aldosterone to renin ratio with MR-proANP, MR-proADM and IMT were assessed using linear regression models stratified for the presence of prediabetes and type 2 diabetes.
  
  
  
  After adjustment for confounding factors, an inverse association of MR-proANP with renin (p = 0.002) and aldosterone (p = 0.021) and a direct association of MR-proADM with renin (p < 0.001) and aldosterone (p = 0.019) were seen in nondiabetic individuals. In diabetic subjects, there was no significant correlation of MR-proANP or MR-proADM with renin or aldosterone. Renin and aldosterone were not directly associated with IMT in non-diabetic subjects and the total cohort, whereas aldosterone was associated with IMT in diabetic participants (p = 0.005).
  
  
  
  This study shows associations between renin, aldosterone and MR-proANP/MR-proADM plasma levels that are altered in type 2 diabetes. Plasma renin and aldosterone are not independent biomarkers for early atherosclerotic damages of the carotid arteries in the general community.
authors: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany. Electronic address: cornelia.then@med.uni-muenchen.de.
authors: Cornelia
authors: C
authors: Then
authors: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
authors: Marietta
authors: M
authors: Rottenkolber
authors: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany.
authors: Andreas
authors: A
authors: Lechner
authors: Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors: Christa
authors: C
authors: Meisinger
authors: Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors: Margit
authors: M
authors: Heier
authors: Department of Internal Medicine II - Cardiology, University of Ulm, Medical Centre, Ulm, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
authors: Wolfgang
authors: W
authors: Koenig
authors: Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Research Unit of Molecular Epidemiology, German Research Center for Environmental Health, Neuherberg, Germany.
authors: Annette
authors: A
authors: Peters
authors: German Diabetes Center, Leibniz Institute at Heinrich Heine University Düsseldorf, Institute of Biometrics and Epidemiology, Düsseldorf, Germany.
authors: Wolfgang
authors: W
authors: Rathmann
authors: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
authors: Martin
authors: M
authors: Bidlingmaier
authors: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany.
authors: Martin
authors: M
authors: Reincke
authors: Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany; Clinical Cooperation Group Diabetes, Ludwig-Maximilians-Universität München and Helmholtz Zentrum München, Munich, Germany.
authors: Jochen
authors: J
authors: Seissler
mesh_terms: D053607:Adrenomedullin / Q000097:blood; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D002339:Carotid Arteries / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010446:Peptide Fragments / Q000737:chemistry*; D011236:Prediabetic State / Q000097:blood*; D011498:Protein Precursors / Q000097:blood; D012083:Renin / Q000097:blood*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; D053607:Adrenomedullin; D000450:Aldosterone; D012083:Renin
keywords: ANP; Adrenomedullin; Aldosterone; Diabetes; MR-proADM; MR-proANP; Renin