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Titolo:
Raised urinary glucocorticoid and adrenal androgen precursors in the urineof young hypertensive patients: possible evidence for partial glucocorticoid resistance
Autore:
Shamim, W; Yousufuddin, M; Francis, DP; Gualdiero, P; Honour, JW; Anker, SD; Coats, AJS;
Indirizzi:
Royal Brompton Hosp, London SW3 6NP, England Royal Brompton Hosp London England SW3 6NP Hosp, London SW3 6NP, England Natl Heart & Lung Inst, London SW3 6NP, England Natl Heart & Lung Inst London England SW3 6NP t, London SW3 6NP, England Middlesex Hosp, London WC1, England Middlesex Hosp London England WC1Middlesex Hosp, London WC1, England Univ Coll London, Sch Med, London WC1, England Univ Coll London London England WC1 London, Sch Med, London WC1, England
Titolo Testata:
HEART
fascicolo: 2, volume: 86, anno: 2001,
pagine: 139 - 144
SICI:
1355-6037(200108)86:2<139:RUGAAA>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
EPITHELIAL SODIUM-CHANNEL; APPARENT MINERALOCORTICOID EXCESS; PRIMARY CORTISOL RESISTANCE; AMBULATORY BLOOD-PRESSURE; BETA-SUBUNIT; ALDOSTERONE SYNTHASE; MISSENSE MUTATION; RATS; GENE; VARIABILITY;
Keywords:
premature hypertension; glucocorticoid resistance; cortisol metabolites; glucocorticoid receptor resistance;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
53
Recensione:
Indirizzi per estratti:
Indirizzo: Shamim, W Royal Brompton Hosp, Sydney St, London SW3 6NP, England Royal Brompton Hosp Sydney St London England SW3 6NP P, England
Citazione:
W. Shamim et al., "Raised urinary glucocorticoid and adrenal androgen precursors in the urineof young hypertensive patients: possible evidence for partial glucocorticoid resistance", HEART, 86(2), 2001, pp. 139-144

Abstract

Objective-To evaluate urinary glucocorticoid excretion profiles in a cohort of recently diagnosed young hypertensive patients. Methods-After excluding patients with secondary causes, 60 individuals with premature hypertension were recruited (diagnosed by ambulatory blood pressure monitoring before the age of 36 years). In addition, 30 older hypertensive controls (age of onset > 36 years, "middle aged hypertensive controls"), and 30 normal controls (age matched to the young hypertensive group) were studied. All provided 24 hour urine collections for mass spectrometry fortotal cortisol metabolites and total androgen metabolites by gas chromatography. Results-Among male patients, those with premature hypertension had higher total urinary excretion of cortisol metabolites (mean (SD), 13 332 (6472) mug/day) than age matched normal controls (7270 (1788) mug/day; p = 0.00001)or middle aged hypertensive controls (8315 (3565) mug/day; p = 0.002). A similar increase was seen among the female patients, although the absolute concentrations were lower. There was no significant difference between middle aged hypertensive patients and normal controls. Urinary total androgen excretion profiles in female patients also showed an unusual increase in the premature hypertension group (2958 (1672) mug/ day) compared with the othergroups (middle aged hypertensive controls, 1373 (748) mug/day, p = 0.0003;normal controls, 1687 (636) mug/day, p = 0.002). In all subjects, serum sodium and creatinine concentrations were within the normal range; serum potassium concentrations were found to be low before the start of treatment. Conclusions-Individuals presenting with premature hypertension have an abnormally high excretion of glucocorticoid metabolites in the urine. While the mechanism remains uncertain, these findings are compatible with partial resistance of the glucocorticoid receptors, with a compensatory increase in cortisol and androgen metabolites. The mineralocorticoid effects of the latter (sodium and water retention) may contribute to an abnormally high bloodpressure and may have implications for targeted selection of first line treatment in young hypertensive patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/12/18 alle ore 23:06:17