正常人の血漿レニン活性・血漿アルドステロン濃度に及ぼす加令・性・月経周期および電解質の影響

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We investigated the influence of age, sex, menstrual cycle and electrolyte balance on the renin-angiotensin-aldosterone (R-A-A) system in 94 healthy subjects, 40 males and 54 females between the ages of 16 and 101. Male and female pre- and postmenopausal groups were divided into 6 subgroups according to their age; G-1 : under 20 years of age, G-2 : 21 to 30, G-3 : 31 to 45, G-4 : 46 to 60, G-5 : 61 to 75 and G-6 : over 76. Premenopausal women were examined in both the follicular and luteal phases. The parameters analyzed were body height, body weight, body surface area (BSA), hematocrit, mean blood pressure (MBP), plasma renin activity (PRA), plasma aldosterone concentration (PAC), plasma electrolytes and urinary excretions of Na, K, creatinine and aldosterone (AER) measured in urine specimen collected over 2-3 hours in the morning. PRA, PAC and AER were measured by radioimmunoassay. 1) PRA and PAC decreased gradually with age in the subjects under 60 years of age. There were no further changes in PRA and PAC in men over 61 y.o. and in postmenopausal women, respectively. 2) In premenopausal women, PRA and PAC were significantly higher in the luteal phase than in the follicular phase. 3) Both PRA and PAC appeared slightly higher in men than in women during the follicular and postmenopausal phases, the differences not being significant. During the luteal phase, PRA and PAC were, however, significantly higher in women than in men. 4) Urinary excretion of Na (mEq/hr) was not significantly different among the groups except for G-1 vs. G-6 in men and the follicular phase vs. postmenopausal women in G-4. Urinary excretion of K and creatinine significantly decreased while plasma K concentraiton increased with age. 5) PRA correlated negatively with urinary excretion of Na or MBP and positively with urinary excretion of creatinine, hematocrit, body height, body weight and BSA. PAC correlated negatively with urinary excretion of Na or MBP and positively with urinary excretion of creatinine, hematocrit and body height. These findings suggest that the decrease of PRA and PAC with age is not due to an increase in salt intake but rather reflects age-related changes in renal function. As to the evaluation of the R-A-A system, we should consider age, sex and stage of menstrual cycle in addition to salt intake, posture and circadian variations.
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正常人の血漿レニン活性・血漿アルドステロン濃度に及ぼす加令・性・月経周期および電解質の影響

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