Abstract
The effect of insulin-induced hypoglycemia and glucose loading on the renin-aldosterone system was studied in 10 normal children and adolescents, aged 8 to 16 years in an attempt to find a simple tool for the evaluation of this system. The nadir of insulin induced hypoglycemia was followed 15 min. later by a 371 ± 139% (m ± SEM) elevation of plasma renin activity (PRA), from a basal level of 2.9 ± 0.4 ng/ml/hour (m ± SEM) to 7.9 ± 1.9 (p< 0.025). Plasma aldosterone levels increased 243 ± 21% (m ± SEM) from a basal level of 7.3 ± 0.7 ng/dl to 19.9 ± 2.3 (p<0.005). A standard oral glucose load (1.75 g/kg body weight) was followed by an insignificant elevation of PRA. Plasma aldosterone levels decreased 53 ± 11% (m ± SEM) 15 min. after the glucose peak, from 10.6 ± 1.1 to 3.9 ± 0.2 ng/dl (p<0.005). The theoretical basis by which insulin-induced hypoglycemia results in the elevation of PRA and aldosterone could be a combination of K+ ion shift, ACTH secretion, catecholamine surge and glucagon rise. All of these are known to be stimulated by insulin hypoglycemia and to stimulate the renin aldosterone system. The aldosterone suppression by the oral glucose load was independent of the PRA. The mechanism of this suppression is still unknown. It is suggested that the ease of administration makes the insulin tolerance and oral glucose tolerance tests useful in the investigation of the renin aldosterone system.
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Hochberg, Z., Dickerman, Z., Kaufman, H. et al. 862 EVALUATION OF THE RENIN-ALDOSTERONE SYSTEM DURING HYPO- AND HYPERGLYCEMIA IN CHILDREN AND ADOLESCENTS. Pediatr Res 12 (Suppl 4), 507 (1978). https://doi.org/10.1203/00006450-197804001-00867
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DOI: https://doi.org/10.1203/00006450-197804001-00867