Pp.39.15: c -344t aldosterone-synthase gene polymorphism and renin-angiotensin-aldosterone system in patients with abdominal obesity

Objective: Renin-Angiotensin-Aldosterone-System plays an important role in the pathophysiology of arterial hypertension (AH) and abdominal obesity(AO). We studied C -344T aldosterone-synthase gene polymorphism, plasma renin activity (PRA) and plasma aldosterone level (PAL) in patients with AO. Design and method: We observed 140 patients with AO (IDF, 2005), 90 females and 50 males (age - 44.6 ± 0.6 years old) and 56 subjects without AO and AH (38 females and 18 males, age - 41.0 ± 1.1 years old). 49.7% of obese patients were hypertensive. C-344T aldosterone-synthase gene polymorphism were determined by PCR, PRA and PLA were determined by radioimmune assay method. Results: PRA was higher in patients with AO versus non-obese subjects (3.0 ± 0.4 ng/ml/hr and 1.8 ± 0.8 ng/ml/hr; p = 0.006). PAL didn’t differ in obese patients and in non-obese subjects (169.1 ± 15.0 pg/ml and 114.7 ± 13.2 pg/ml; p > 0.05). PRA was higher in patients with AO and AH versus obese patients without AH (3.6 ± 0.6 ng/ml/hr and 2.2 ± 0.4 ng/ml/hr, respectively; p = 0.04). PAL in obese patients with and without AH didn’t differ (185.3 ± 23.8 pg/ml and 152.6 ± 18.1 pg/ml, p > 0.05). The frequency of different genotypes (C -344 C, C - 344 T, T -344 T) aldosterone-synthase gene in patients with AO and in general population didn’t differ. Levels of systolic and diastolic blood pressure were higher in obese patients with -344T allele (p = 0.04). The frequency of the CC genotype in obese patients with AH was lower than the frequency of CC genotype in patients with AO and without AH (2.9% and 15.2%; p = 0.008). PRA and PLA didn’t differ between obese patients with gomozygous CC and obese patients with -344T allele (PRA: 2.6 ± 0.9 ng/ml/hr and 2.8 ± 0.5 ng/ml/hr, p > 0.05; PAL: 119.5 ± 19.5 pg/ml and 148.0 ± 15.3 pg/ml, p > 0.05). We found a significant association between AH and -344T allele (odds ratio (OR) = 13.46; 95% confidence interval (CI) 3.01÷59.04; p = 0.004; n = 132). Conclusions: Plasma renin activity was higher in patients with abdominal obesity and arterial hypertension. Obese patients with -344T allele of aldosterone-synthase gene had 13.46% risk of arterial hypertension.