Renin-Angiotensin-Aldosterone System, Glucose Metabolism and Incident Type 2 Diabetes Mellitus: MESA

Background Mechanistic studies suggest that aldosterone impairs glucose metabolism. We investigated the cross-sectional associations of aldosterone and plasma renin activity with fasting plasma glucose, insulin resistance ( IR ), β-cell function, and longitudinal association with incident diabetes m...

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Bibliographic Details
Published in:Journal of the American Heart Association 2018-09, Vol.7 (17), p.e009890-e009890
Main Authors: Joseph, Joshua J, Echouffo Tcheugui, Justin B, Effoe, Valery S, Hsueh, Willa A, Allison, Matthew A, Golden, Sherita H
Format: Article
Language:English
Subjects:
African Americans
Aged
aldosterone
Aldosterone - metabolism
Asian Americans
Blood Glucose - metabolism
Cohort Studies
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - metabolism
European Continental Ancestry Group
Female
Hispanic Americans
Humans
Incidence
Insulin Resistance
Insulin-Secreting Cells - metabolism
Linear Models
Male
Middle Aged
Multivariate Analysis
Original Research
Proportional Hazards Models
Prospective Studies
race and ethnicity
Renin - metabolism
Renin-Angiotensin System
type 2 diabetes mellitus
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Summary:Background Mechanistic studies suggest that aldosterone impairs glucose metabolism. We investigated the cross-sectional associations of aldosterone and plasma renin activity with fasting plasma glucose, insulin resistance ( IR ), β-cell function, and longitudinal association with incident diabetes mellitus among adults in MESA (the multiethnic study of atherosclerosis) prospective cohort study. Methods and Results Homeostatic model assessment of IR ( HOMA 2- IR ) and HOMA 2-β were used to estimate IR and β-cell function, respectively. Incident diabetes mellitus was defined as fasting plasma glucose ≥126 mg/dL or anti-diabetic medication use at follow-up. Linear regression was used to examine cross-sectional associations of aldosterone with fasting plasma glucose, HOMA 2- IR and HOMA 2-β; Cox regression was used to estimate hazard ratios ( HR ) for incident diabetes mellitus with multivariable adjustment. There were 116 cases of incident diabetes mellitus over 10.5 years among 1570 adults (44% non-Hispanic white, 13% Chinese American, 19% Black, 24% Hispanic American, mean age 64±10 years, 51% female). A 100% increase in log-aldosterone was associated with a 2.6 mg/dL higher fasting plasma glucose, 15% higher HOMA 2- IR and 6% higher HOMA 2-β ( P
ISSN:2047-9980
2047-9980
DOI:10.1161/jaha.118.009890