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Journal of Renin-Angiotensin-Aldosterone System
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The renin-angiotensin-aldosterone system is suppressed in adults with Type 1 diabetes

Mats Bojestig

Department of Medicine and Care, University Hospital of Linkoping

Fredrik H Nystrom

Department of Medicine and Care, University Hospital of Linkoping, fredrik.nytrom@ lio.se

Hans J Arnqvist

Department of Medicine and Care, University Hospital of Linkoping

Johnny Ludvigsson

Department of Pediatrics, University Hospital of Linköping, Sweden

Bengt E Karlberg

Department of Medicine and Care, University Hospital of Linkoping

Poor glycaemic control and high blood pressure are two important risk factors for the development of retinopathy and nephropathy in Type 1 diabetes. The renin-angiotensin-aldosterone system (RAAS) may be involved in this process, since treatment with angiotensin-converting enzyme (ACE) inhibitors postpones the development of these complications. We investigated whether plasma renin activity (PRA), plasma angiotensin II (Ang II) and atrial natriuretic peptide (ANP) differed in Type 1 diabetic patients compared with healthy controls. We recruited 80 patients with Type 1 diabetes of more than 10 years' duration and 75 age-matched controls. We found that PRA and Ang II concentrations were significantly lower in patients than in the controls. The levels of ANP, on the other hand, were higher in patients than in controls. PRA correlated negatively to the mean value of HbA1c during the previous five years. PRA and Ang II were significantly lower in patients with mean HbA1c >8.4% compared with those with mean HbA1c <7.2%. In summary, we found patients with Type 1 diabetes to have RAAS suppression and increased ANP levels, suggesting a state of fluid retention.

Key Words: renin • angiotensin II • atrial natriuretic peptide • albuminuria • glycaemic control • type 1 diabetes

Journal of Renin-Angiotensin-Aldosterone System, Vol. 1, No. 4, 353-356 (2000)
DOI: 10.3317/jraas.2000.065


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