RESUMO
Isolated nocturnal hypertension (INHT), defined as nighttime elevated blood pressure (BP) with normal daytime BP assessed by ambulatory BP monitoring, is associated with higher cardiovascular morbidity and mortality. We hypothesized that an alteration in the circulating renin-angiotensin system (RAS) contributes to INHT development. We examined circulating levels of angiotensin (Ang) (1-7) and Ang II and ACE2 activity in 26 patients that met the INHT criteria, out of 50 that were referred for BP evaluation (62% women, 45â±â16âyears old). Those with INHT were older, had a higher BMI, lower circulating Ang-(1-7) (Pâ=â0.002) and Ang II levels (Pâ=â0.02) and no change in ACE2 activity compared to those normotensives. Nighttime DBP was significantly correlated with Ang-(1-7) and Ang II levels. Logistic regression showed significant association in Ang-(1-7) and Ang II levels with INHT. Our study reveals differences in circulating RAS in individuals with INHT.
Assuntos
Angiotensina II , Angiotensina I , Hipertensão , Fragmentos de Peptídeos , Humanos , Angiotensina I/sangue , Feminino , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Hipertensão/sangue , Hipertensão/fisiopatologia , Adulto , Angiotensina II/sangue , Sistema Renina-Angiotensina/fisiologia , Ritmo Circadiano , Pressão Sanguínea , Enzima de Conversão de Angiotensina 2/sangue , Monitorização Ambulatorial da Pressão Arterial , Peptidil Dipeptidase A/sangueRESUMO
BACKGROUND: Besides its counterbalancing role of the renin-angiotensin system (RAS), angiotensin-converting enzyme (ACE) 2 is the receptor for the type 2 coronavirus that causes severe acute respiratory syndrome, the etiological agent of COVID-19. COVID-19 is associated with increased plasmatic ACE2 levels, although conflicting results have been reported regarding angiotensin (Ang) II and Ang-(1-7) levels. We investigated plasmatic ACE2 protein levels and enzymatic activity and Ang II and Ang-(1-7) levels in normotensive and hypertensive patients hospitalized with COVID-19 compared to healthy subjects. METHODS: Ang II and Ang-(1-7), and ACE2 activity and protein levels were measured in 93 adults (58 % (n = 54) normotensive and 42 % (n = 39) hypertensive) hospitalized with COVID-19. Healthy, normotensive (n = 33) and hypertensive (n = 7) outpatient adults comprised the control group. RESULTS: COVID-19 patients displayed higher ACE2 enzymatic activity and protein levels than healthy subjects. Within the COVID-19 group, ACE2 activity and protein levels were not different between normotensive and hypertensive-treated patients, not even between COVID-19 hypertensive patients under RAS blockade treatment and those treated with other antihypertensive medications. Ang II and Ang-(1-7) levels significantly decreased in COVID-19 patients. When COVID-19 patients under RAS blockade treatment were excluded from the analysis, ACE2 activity and protein levels remained higher and Ang II and Ang-(1-7) levels lower in COVID-19 patients compared to healthy people. CONCLUSIONS: Our results support the involvement of RAS in COVID-19, even when patients under RAS blockade treatment were excluded. The increased circulating ACE2 suggest higher ACE2 expression and shedding.
Assuntos
COVID-19 , Hipertensão , Adulto , Angiotensina II/metabolismo , Enzima de Conversão de Angiotensina 2 , Humanos , Peptidil Dipeptidase A/metabolismo , Sistema Renina-AngiotensinaRESUMO
La hemoglobina glucosilada (HbA1c) es un parámetro de gran valor para evaluar el grado de control glucémico a largo plazo en personas con diabetes (DM). Sin embargo, la carencia de estándares adecuados hace que frecuentemente los resultados obtenidos por diferentes métodos de valoración no resulten comparables,provocando en el médico dificultades para evaluar el comportamiento metabólico de su paciente. En este trabajo se evaluó el grado de correlación y la posibilidad de comparación de los valores de HbA1c determinados por tres métodos utilizados en nuestro medio basados en diferentes principios analíticos y que no presentan las interferencias habituales del método de minicolumnas de cromatografía de intercambio iónico. Para ello medimos la HbA1c en 44 muestras de sangre de personas con y sin DM por el método Tina Quant HbA1c ll (TQ, Roche Diagnostics), el método DCA 2000 (DCA, Bayer Argentina) y el de Glicohemoglobina lMx (lMx, Abbott Laboratories Argentina). Los resultados de cada uno de ellos fueron ajustados matemáticamente al método cromatográfico de HPLC elegido internacionalmente como referencia...
Assuntos
Humanos , Diabetes Mellitus , Hemoglobinas GlicadasRESUMO
La hemoglobina glucosilada (HbA1c) es un parámetro de gran valor para evaluar el grado de control glucémico a largo plazo en personas con diabetes (DM). Sin embargo, la carencia de estándares adecuados hace que frecuentemente los resultados obtenidos por diferentes métodos de valoración no resulten comparables,provocando en el médico dificultades para evaluar el comportamiento metabólico de su paciente. En este trabajo se evaluó el grado de correlación y la posibilidad de comparación de los valores de HbA1c determinados por tres métodos utilizados en nuestro medio basados en diferentes principios analíticos y que no presentan las interferencias habituales del método de minicolumnas de cromatografía de intercambio iónico. Para ello medimos la HbA1c en 44 muestras de sangre de personas con y sin DM por el método Tina Quant HbA1c ll (TQ, Roche Diagnostics), el método DCA 2000 (DCA, Bayer Argentina) y el de Glicohemoglobina lMx (lMx, Abbott Laboratories Argentina). Los resultados de cada uno de ellos fueron ajustados matemáticamente al método cromatográfico de HPLC elegido internacionalmente como referencia...(AU)
