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Aldosteronismo autónomo relacionado con la edad

Kazutaka Nanba1, Anand Vaidya1, Gordon H Williams1

  • 1From Departments of Molecular and Integrative Physiology & Internal Medicine, University of Michigan, Ann Arbor (K.N., I.Z., W.E.R.); Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (A.V., G.H.W.); and Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor (T.E., W.E.R.).

Circulation
|June 2, 2017
PubMed
Resumen

El envejecimiento afecta la producción de aldosterona, aumentando el riesgo de enfermedades cardiovasculares. Los individuos mayores muestran una reducción de la expresión normal del CYP11B2 pero más agrupaciones celulares productoras de aldosterona, lo que sugiere un aldosteronismo autónomo.

Palabras clave:
envejecimientoAldosterona y sus derivadosGrupo de células productoras de aldosteronaEl citocromo P-450 y el CYP11B2Aldosteronismo primarioel renino

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Área de la Ciencia:

  • Endocrinología
  • Investigación de las enfermedades cardiovasculares
  • Biología del envejecimiento

Sus antecedentes:

  • El envejecimiento y la secreción inadecuada de aldosterona son factores de riesgo de enfermedad cardiovascular.
  • Los efectos específicos del envejecimiento sobre la secreción de aldosterona y la fisiología siguen sin estar claros.

Objetivo del estudio:

  • Investigar la relación entre el envejecimiento y la expresión de la aldosterona sintasa (CYP11B2) en las glándulas suprarrenales.
  • Evaluar la asociación entre la edad y la fisiología del sistema renina-angiotensina-aldosterona (RAAS) en humanos.

Principales métodos:

  • Se examinó la expresión de CYP11B2 y los grupos de células productoras de aldosterona en 127 glándulas suprarrenales humanas (de 9 meses a 68 años) utilizando inmunohistoquímica.
  • Se analizó la fisiología del RAAS en 677 participantes (de 18 a 71 años) bajo dietas altas y restringidas en sodio utilizando regresión lineal multivariable.

Principales resultados:

  • La expresión adrenal de CYP11B2 disminuyó con la edad, mientras que los grupos celulares productores de aldosterona aumentaron.
  • La edad avanzada se relacionó con una mayor proporción de aldosterona a renina en las dietas altas en sodio.
  • La respuesta de la aldosterona a la restricción de sodio se redujo en las personas mayores.

Conclusiones:

  • El envejecimiento está asociado con una reducción de la expresión normal del CYP11B2 y un aumento de los grupos celulares productores de aldosterona en la glándula suprarrenal.
  • Este patrón sugiere un aldosteronismo autónomo relacionado con la edad y una fisiología alterada de la aldosterona.
  • Estos hallazgos pueden explicar el aumento del riesgo cardiovascular en las poblaciones envejecidas.