Sep 16, 1976

Big renin and biosynthetic defect of aldosterone in diabetes mellitus

The New England Journal of Medicine
A deLeivaP Zager


To determine the cause of selective aldosterone deficiency in two patients with diabetes mellitus, studies of renin and of aldosterone-precursor metabolites were performed under conditions of sodium depletion and ACTH stimulation. Plasma renin concentration was elevated in both patients, and stimulated plasma renin activity was low in one and normal in the other. Fractionation of plasma extracts demonstrated the presence of "big renin," a relatively inactive precursor of renin. Metabolites of aldosterone precursors were increased, suggesting deficient 18-hydroxylase in one patient and dehydrogenase in the other. The results suggest that hypoaldosteronism in diabetic patients may result from combined defects in both renin and aldosterone biosynthesis.

Mentioned in this Paper

Aldosterone Measurement
POMC wt Allele
Thyroid Hormone Plasma Membrane Transport Defect
Renin and Aldosterone
Corticosterone 18-monooxygenase
Renin Measurement
Chemical Fractionation

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