Renin-angiotensin-aldosterone system variations in type 2 diabetes mellitus patients with different complications and treatments: Implications for glucose metabolism

作者：Ningning Wang, Junhui Li, Erjun Tian, Shutong Li, Shuai Liu, Fei Cao, Junfeng Kong, Baohong Yue · 发表于：PLoS ONE · 年份：2025 · DOI：10.1371/journal.pone.0316049 · 被引用次数：5 · 研究领域：Diabetes Treatment and Management、Renin-Angiotensin System Studies、Hormonal Regulation and Hypertension

BACKGROUND: The presence of hypertension and various acute or chronic complications may affect the renin-angiotensin-aldosterone system (RAAS) in patients with type 2 diabetes mellitus (T2DM), which plays a crucial role in the regulation of glucose metabolism. However, the quantitative distribution of the RAAS components in relation to the progression of T2DM and the treatment of hyperglycemia and hypertension, as well as their association with different stages of complications and glucose metabolism, has not been well studied. METHODS: We enrolled a total of 151 patients with T2DM and essential hypertension, 40 patients with T2DM and normotension, and 46 healthy controls in the study. They were categorized into subgroups based on criteria for diabetic complications. Statistical analyses, including Spearman rank correlation and multiple linear regression, were conducted to assess the relationship between RAAS components and glucose metabolism indexes such as HbA1c, FBG, CP, HOMA-β, HOMA-IR, and UACR. RESULTS: The results revealed significant differences in AII, ALD, REN, and ARR levels across various complication subgroups. Notably, the concentrations of ALD and REN exhibited a consistent trend, while ARR showed an opposite trend to the REN concentration. More than 60% of hypertensive patients were treated with ACEI/ARBs and calcium channel blockers, while 29.8% of the patients were prescribed β-blockers, resulting in decreased REN and increased ARR levels. All T2DM patients ...