HYPERINSULINEMIA LEADS THE ELEVATION OF PLASMA ALDOSTERONE CONCENTRATION INDEPENDENTLY WITH OBESITY, DYSLIPIDEMIA, AND INSULIN RESISTANCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

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The study was to define plasma insulin level with the association of renin-angiotensin-aldosterone system activity in patients with type 2 diabetes. One hundred fi fty type 2 diabetic patients and 24 non-diabetic subjects were studied. There was no statistical diff erence between the two groups in age, gender, the prevalence of hypertension, and serum potassium concentration. Plasma aldosterone concentration(PAC) was signifi cantly higher in type 2 diabetics than that in non-diabetic subjects(10.4±4.9 vs. 7.4±3.7 ng/dl；p=0.004)； however plasma renin activity(PRA) did not diff er signifi cantly between the two groups. In diabetic patients, PAC correlated signifi cantly with body mass index(BMI), fasting plasma insulin(F-IRI), homeostasis model assessment insulin resistance (HOMA-R), urinary C-peptide excretion(U-CPR), triglycerid(e TG), and high-density lipoprotein cholestero(l HDL-C). PRA correlated signifi cantly with F-IRI and HOMA-R, but did not correlate with BMI, U-CPR, TG, and HDL-C. The additional contribution of U-CPR in predicting PAC was signifi cant after adjustment for age, BMI, F-IRI, TG, HDL-C, and PRA(β=0.204, p=0.016). These fi ndings indicate that hyperinsulinemia may aff ect the increase in PAC unrelated with obesity, dyslipidemia, insulin resistance that are components of metabolic syndrome in patients with type 2 diabetes.

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