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Aldosterone, renin activation may increase risk for diabetes in blacks
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In black adults, activation of the renin-angiotensin-aldosterone system may significantly influence the development of insulin resistance and diabetes, according to study findings published in The Journal of Clinical Endocrinology & Metabolism.
Sherita Hill Golden, MD, MHS, associate professor at Johns Hopkins University School of Medicine, and colleagues evaluated data from the Jackson Heart Study on 3,234 black adults during a median of 8 years to determine the links between aldosterone and renin, and insulin resistance, beta-cell function and incident diabetes.
Sherita Hill Golden
Among participants who did not develop diabetes, every 1% increase in log-transformed aldosterone was linked to a 0.18% higher log-transformed homeostasis model assessment for insulin resistance (HOMA-IR) and 0.1% higher log-transformed HOMA-beta (P < .001).
Throughout follow-up, 554 participants developed diabetes. Higher quintiles of log-transformed aldosterone was linked to a significantly higher risk for diabetes (HR = 1.78; fifth vs. first quintile, 95% CI, 1.35-2.34) after full adjustment. Compared with the first quintile of log-transformed renin, the fifth quintile was linked to a 35% higher risk for incident diabetes (HR = 1.35; 95% CI, 1.06-1.72).
“Our study suggests that activation of the [renin-angiotensin-aldosterone system] with higher levels of aldosterone and renin are associated with insulin resistance, compensatory increased beta-cell function and incident diabetes in [African Americans], implicating this hormonal pathway not only in the pathophysiology of hypertension, but also diabetes,” the researchers wrote. “Further research exploring the impact of the [renin-angiotensin-aldosterone system] and [renin-angiotensin-aldosterone system] blockage on diabetes prevention in [African Americans], a population with a high prevalence of hypertension, is paramount given the potential to reduce the disparities in diabetes prevalence and cardiometabolic health in [African Americans].” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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