Diabetic Patients With Hypertension, The Plasma Tail Of Vasopressin, Adrenomedullin Level Changes And Clinical Significance

Objective:To observe the changes of plasma levels of UrotensinⅡ(UⅡ),endothelin(ET),adrenomedullin(ADM) and nitric oxide(NO) in diabetic patients complicated with hypertension , to study its effect in the development of diabetic patients with hypertension and to observe the influence of quinapril on plasma levels of UⅡ,ET,ADM and NO in diabetic patients with hypertension.Methods: Accoding to WHO diagnostic standard 40 type 2 diabetic patients with hypertension were selected, 20 simple diabetic patients and 20 normal control subjects were also selected.The plasma levels of UⅡ,ET,ADM and NO were measured in diabetic patients with hypertension before and after treatment with quinapril,simple diabetic patients and normal control subjects . Plasma UⅡ,ADM and ET concentrations were measured by radioimmunoassay and the serum concentration of NO by spectrophotography .Results: The plasma levels of UⅡare 1.72±0.14pmol/L, the plasma levels of ET are 37.06±5.86ng/L,the plasma levels of ADM are 14.30±2.65ng/L and the plasma levels of NO are 53.13±3.85umol/L, in control group. The plasma levels of of UⅡare 3.80±1.11pmol/L, the plasma levels of ET are 53.06±7.39ng/L,the plasma levels of ADM are 26.29±2.24ng/L and the plasma levels of NO are 80.96±4.94umol/L,in simple diabetic patients. The plasma levels of UⅡare 9.99±1.60pmol/L, the plasma levels of ET are 111.04±4.81ng/L,the plasma levels of ADM are 50.52±3.34ng/L and the plasma levels of NO are 43.40±1.60umol/L, in diabetic patients with hypertension.The plasma levels of UⅡ,ET and ADM were significantly higher in diabetic patients with hypertension than that of simple diabetic patients without hypertension(P<0.01).The plasma levels of NO were significantly lower in diabetic patients with hypertension than that of simple diabetic patients without hypertension(P<0.01). A positive correlation was found between plasma level of UⅡand MAP in the diabetic patients with hypertension (r=0.509, p < 0.01). The plasma level of ET showed positive correlation with MAP(r=0.434,P<0.01).A positive correlation was also found between plasma level of ADM and MAP (r=0.670,P<0.01).But the plasma level of NO showed negative correlation with MAP(r=-0.519,P<0.01). The plasma level of UⅡhad positive correlation with ET and ADM respectively(r=0.651,P<0.01,r=0.586,P<0.01). A negative correlation was found between the plasma level of UⅡand NO(r=-0.577,P<0.01).After treatment with quinapril the plasma levels of UⅡ,ET and ADM were significantly lower than before treatment(p<0.01), the plasma levels of NO were significantly higher than before treatment(p<0.01).Conclusion:1. The plasma levels of UⅡ,ET and ADM increased and the plasma levels of NO were decreased in the diabetic patients with hypertension.2. The plasma levels of UⅡ,ET and ADM showed positive correlation with MAP and the plasma levels of NO had negative correlation with MAP in the diabetic patients with hypertension.3. The plasma levels of UⅡshowed positive correlation with ET and ADM,While had a negative correlation with NO.4. The imbalance of UⅡ,ET,ADM and NO may play an important role in the development of the diabetic patients with hypertension.5.The plasma levels of UⅡ,ET and ADM were decreased, the plasma levels of NO were increased in the diabetic patients with hypertension after treatment with quinapril.