Page 84 - GPD-1-2

Gene & Protein in Disease Diagnosis and treatment of aldosterone-related diseases

the heart, brain, and kidney, through inflammatory aldosterone together, in excess, promote inflammation,
responses . It is activated in a mineralocorticoid receptor fibrosis, and vascular remodeling in various target organs.
[3]
(MR)-dependent and -independent manner through both, Therefore, compared with essential hypertension (EH), an
genomic and non-genomic pathways, but its effects are excess of aldosterone caused by PA is more likely to induce
mediated primarily through the MR. On binding to MR, cardiovascular complications, including coronary artery
the aldosterone-MR complex is translocated to the nucleus disease, myocardial infarction, stroke, transient ischemic
[10]
to regulate gene expression (genomic pathways) . Non- attack, atrial fibrillation, heart failure, and other diseases .
[4]
genomic effects, which may be mediated by MR or other
receptors (e.g., G protein-coupled estrogen receptor I or 2.2. Relationship between aldosterone and diabetes
angiotensin receptor Type I), are exerted within minutes, Diabetes is a hyperglycemic metabolic disease caused by
independent of transcription or translation. Whether insulin deficiency or insulin insensitivity. The number
through aldosterone itself or other receptors, aldosterone of diabetic patients is gradually increasing with the
can affect vascular smooth muscle cells and endothelial improvement of the population’s standard of living .
[11]
function without involving MR . As of 2021, statistics from the International Diabetes
[5]
Federation have shown that there are about 537 million
Therefore, the early detection and regulation of
aldosterone levels are crucial for the prevention of chronic diabetic patients worldwide, of which the number of adult
diabetic patients in China is about 140 million; moreover,
metabolic diseases, such as hypertension, diabetes, and the trend has been increasing year after year with the
atherosclerosis . Considering the importance of early average age of patients decreasing. Although the specific
[6]
detection of aldosterone levels, this review focuses pathogenesis of diabetes is still unclear, islet B cell damage
on aldosterone-related diseases, the clinical detection has become a recognized pathogenesis and basis for the
methods, and the corresponding treatment methods.
disease. According to several reports, excess aldosterone
2. Relationship between aldosterone and may easily lead to decreased responsiveness of peripheral
diseases target organs such as liver and skeletal muscle to insulin.
In addition, increased aldosterone levels not only affect
2.1. Relationship between aldosterone and the function and survival of islet B cells, but also lead
hypertension to oxidative stress in islet B cells, which may, in turn,
result in functional impairment and apoptosis of islet B
Hypertension is a chronic disease that is prevalent cells [12,13] . There are many reasons for islet B cell damage:
worldwide. There are about 245 million hypertensive High glucose and lipids, inflammatory factors, and
patients in China, and the prevalence is still rising. common mineralocorticoids and glucocorticoids, among
Hypertension can be divided into primary hypertension which aldosterone is an indispensable mineralocorticoid,
and secondary hypertension. The causes of primary involved in physiological regulation and the regulatory
hypertension are unknown, and there is no cure for it. system of RAAS . On RAAS activation, the level of
[14]
Secondary hypertension is a condition that occurs during aldosterone increases, which leads to metabolic diseases,
the onset of certain diseases and resolves when the primary such as diabetes, hypertension, and obesity. According to
disease is cured . Among them, primary aldosteronism epidemiological data, there is a gradual increase in plasma
[7]
(PA), which is related to abnormal aldosterone secretion, is aldosterone level in diabetic patients .
[12]
one of the common causes of secondary hypertension. Its
clinical manifestations include hypertension, hypokalemia, In a study of safflower ginger leaf aqueous extracts
and decreased renin secretion. in diabetes mellitus, streptozotocin-induced mice were
divided into a control group (treated with distilled water),
The synthesis of physiological aldosterone is mainly HC group (Hedychium coronarium and ginger lily extract),
regulated by potassium ions and the renin-angiotensin- and SO group (ginger lily, a supplement that aids blood
aldosterone system (RAAS); it also has an acute sugar regulation and contains two substances: Red yeast
response to adrenocorticotropic hormone . RAAS is rice [RYR, 15%] and HC [7.2%], called SugarOut). After
[8]
usually activated in the context of intravascular volume dissolving the two test substances in distilled water, the mice
depletion or decreased renal artery perfusion. It increases were gasserized in accordance with the dosage standards in
intravascular volume by promoting sodium and water FDA guideline. Fasting glucose and oral glucose tolerance
reabsorption in distal renal tubules and collecting ducts. tests as well as aldosterone and insulin tests were performed.
The hyperactivation of the renal MR by aldosterone leads to The results showed that in the detection of fasting blood
intravascular volume expansion, which increases the risk of glucose and glucose tolerance, the rate of weight gain of
hypertension with or without hypokalemia . Sodium and mice after gastric HC and SO was slower than that of the
[9]

Volume 1 Issue 2 (2022) 2 https://doi.org/10.36922/gpd.v1i2.136