TY - JOUR
T1 - Aldosterone, renin, and diabetes mellitus in African Americans
T2 - The Jackson heart study
AU - Joseph, Joshua J.
AU - Echouffo-Tcheugui, Justin B.
AU - Kalyani, Rita R.
AU - Yeh, Hsin Chieh
AU - Bertoni, Alain G.
AU - Effoe, Valery S.
AU - Casanova, Ramon
AU - Sims, Mario
AU - Correa, Adolfo
AU - Wu, Wen Chih
AU - Wand, Gary S
AU - Golden, Sherita Hill
N1 - Funding Information:
We thank the other investigators, the staff, and the participants of the Jackson Heart Study for their valuable contributions. J.J. was supported by Institutional Training Grant T32 DK062707 from the National Institute of Diabetes and Digestive and Kidney Diseases. The Jackson Heart Study is supported by Contracts HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, and HHSN268201300050C from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities.
Publisher Copyright:
Copyright © 2016 by the Endocrine Society.
PY - 2016/4
Y1 - 2016/4
N2 - Context: Previous research has suggested that activation of the renin-angiotensin-aldosterone system may promote insulin resistance and β-cell dysfunction, but the association with incident diabetes in African Americans is unknown. Objective: We examined the association of aldosterone and renin with insulin resistance, β-cell function, and incident diabetes in a large African American cohort. Design: The Jackson Heart Study is a prospective study of the development and progression of cardiovascular disease in African Americans. Setting: Participants were recruited from the tricounty area of metropolitan Jackson, Mississippi. Participants: A total of 5301 African American adults, aged 21-94 years, were assessed at baseline and through 12 years of follow-up. Data on aldosterone, renin, and risk factors were collected at baseline (2000-2004). Diabetes (fasting glucose ≥ 126 mg/dL, physician diagnosis, use of diabetes drugs, or glycated hemoglobin ≥ 6.5%) was assessed at baseline and through 12 years of follow-up. Participants were excluded for missing data on baseline covariates or diabetes follow-up. Cox regression was used to estimate hazard ratios (HR) for incident diabetes using sequential modeling adjusting for age, sex, education, occupation, systolic blood pressure, current smoking, physical activity, dietary intake, and body mass index. Exposures: Aldosterone, renin, and diabetes risk factors were measured. Outcomes: Outcomes included the homeostatic model assessment of insulin resistance (HOMA-IR) and incident diabetes. Results: Among 3234 participants over a median of 8.0 years of follow-up, there were 554 cases of incident diabetes. Every 1% increase in log-transformed aldosterone was associated with a 0.18% higher log-transformed HOMA-IR in cross-sectional analyses of nondiabetic participants (P < .001). Log-transformed aldosterone and renin levels in the fifth vs first quintile were associated with a 78% (HR 1.78, 95% confidence interval 1.35-2.34) and 35% (HR 1.35, 95% confidence interval 1.06-1.72) increase in diabetes risk, respectively, in fully adjusted models. Conclusions: Activation of the renin-angiotensin-aldosterone system may play a significant role in the development of insulin resistance and diabetes in African Americans.
AB - Context: Previous research has suggested that activation of the renin-angiotensin-aldosterone system may promote insulin resistance and β-cell dysfunction, but the association with incident diabetes in African Americans is unknown. Objective: We examined the association of aldosterone and renin with insulin resistance, β-cell function, and incident diabetes in a large African American cohort. Design: The Jackson Heart Study is a prospective study of the development and progression of cardiovascular disease in African Americans. Setting: Participants were recruited from the tricounty area of metropolitan Jackson, Mississippi. Participants: A total of 5301 African American adults, aged 21-94 years, were assessed at baseline and through 12 years of follow-up. Data on aldosterone, renin, and risk factors were collected at baseline (2000-2004). Diabetes (fasting glucose ≥ 126 mg/dL, physician diagnosis, use of diabetes drugs, or glycated hemoglobin ≥ 6.5%) was assessed at baseline and through 12 years of follow-up. Participants were excluded for missing data on baseline covariates or diabetes follow-up. Cox regression was used to estimate hazard ratios (HR) for incident diabetes using sequential modeling adjusting for age, sex, education, occupation, systolic blood pressure, current smoking, physical activity, dietary intake, and body mass index. Exposures: Aldosterone, renin, and diabetes risk factors were measured. Outcomes: Outcomes included the homeostatic model assessment of insulin resistance (HOMA-IR) and incident diabetes. Results: Among 3234 participants over a median of 8.0 years of follow-up, there were 554 cases of incident diabetes. Every 1% increase in log-transformed aldosterone was associated with a 0.18% higher log-transformed HOMA-IR in cross-sectional analyses of nondiabetic participants (P < .001). Log-transformed aldosterone and renin levels in the fifth vs first quintile were associated with a 78% (HR 1.78, 95% confidence interval 1.35-2.34) and 35% (HR 1.35, 95% confidence interval 1.06-1.72) increase in diabetes risk, respectively, in fully adjusted models. Conclusions: Activation of the renin-angiotensin-aldosterone system may play a significant role in the development of insulin resistance and diabetes in African Americans.
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U2 - 10.1210/jc.2016-1002
DO - 10.1210/jc.2016-1002
M3 - Article
C2 - 26908112
AN - SCOPUS:84994746788
SN - 0021-972X
VL - 101
SP - 1770
EP - 1778
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 4
ER -