Study On Reference Interval And Influencing Factors Of Plasma Aldosterone And Direct Renin Concentrations And Their Ratios In Orthostatic Residents Of Yunnan

Objective(s)The reference interval of the vertical plasma aldosterone concentration(Plasma aldosterone concentration,PAC),the vertical direct renin concentration(Direct renin concentration,DRC),and the ratio of the plasma aldosterone concentration to the direct renin concentration(Aldosterone to renin ratio,ARR)of healthy residents in Yunnan Province were explored,so as to provide a basis for the clinical diagnosis of primary aldosteronism.MethodsAccording to the research scheme of the Monitoring of Cardiovascular Disease and Risk Factors for Chinese Residents(2020),9,834 residents aged 18 and above in Yunnan Province were selected by stratified multi-stage random sampling,including demographic characteristics,smoking,alcohol consumption,tea drinking,blood lipids,renal dysfunction,height,weight,waist,blood pressure,uric acid,blood glucose,rensterone,ARR,and 6,699 persons were selected according to the inclusion and exclusion criteria.The reference interval of aldosterone,renin and ARR for healthy residents in Yunnan province was established,and PAC,DRC and ARR were divided into low,medium and high according to their respective reference intervals.First,statistically significant variables were screened out by univariate correlation analysis,and then orderly multiple logistic regression model was used to analyze the influencing factors of aldosterone grade,renin grade and ARR grade.Results1.A total of 9834 cases were included,including 4862 males,accounting for49.5%,and 4972 females,accounting for 50.5%.The age range was 18 to 98 years,with a mean age of 44.06 ± 18.00 years.2.A total of 6699 eligible residents were included,and reference intervals for PAC,DRC and ARR were established.The range of medical reference value adopts the reference limit of 2.5% digits(P2.5)to 97.5% digits(P97.5).The overall population PAC reference ranges from 2.85～30.50ng/d L,DRC from2.58～104.77 u IU/ml,and ARR from 0.08 to 2.88(n g/d L)/(u IU / ml).3.Differences in PAC,DRC and ARC levels between sexenders(P <0.05),PRC and DRC(P> 0.05),and ARR levels(P <0.05).(1)The reference value interval of PAC for residents in Yunnan Province was:3.16 ～ 35.28 n g/d L for men and 2.55 ～ 24.59 n g/d L for women;(2)The reference value interval of DRC in Yunnan province residents was: 2.18 ～94.54 u IU / ml for men and 3.35 ～ 109.59 u IU / ml for women;(3)The ARR reference value interval of residents in Yunnan Province,Young men(18-44 years old)were 0.09-3.27(n g/d L)/(u IU / ml)and 0.07-1.99(n g/d L)/(u IU / ml),respectively;Middle-aged men(45-64 years old)were 0.10-3.91(n g/d L)/(u IU / ml)and 0.07-1.99(n g/d L)/(u IU / ml);The elderly population(65 years old)were 0.09-4.71(n g/d L)/(u IU / ml)and 0.07-2.14(n g/d L)/(u IU / ml),respectively.4.PAC,DRC,ARC levels were classified according to low,medium and high,PAC grade: low(<2.85 n g/d L),Medium(2.85～30.50ng/d L),High(> 30.50 n g/d L);DRC: Low(<2.58 u IU / ml),Medium(2.58 ～ 104.77 u IU / ml),High(> 104.77 u IU /ml);ARR: low(<0.08 n g/d L / u IU / ml),Medium(0.08～2.88(n g/d L)/(u IU / ml)),High(> 2.88(n g/d L)/(u IU / ml)).PAC,DRC,ARR grade as the dependent variable,multiple orderly logistic regression analysis,the results showed that:(1)ethnic minorities,smoking,egg eating high frequency,tumor,hyperuricemia,unmarried,the shorter the day sleep,the higher the platelet count,the higher the fat content,the possibility of PAC increased a grade is higher.(2)Han nationality,salt restriction,high frequency of eating fish and shrimp,cardiomyopathy,higher basal metabolic rate,the shorter the sleep on rest days,the higher the possibility of a DRC increase.(3)Han nationality,45 to 64 years old(compared to 18 to 44 years old),the higher the frequency of milk consumption,regular exercise,the longer the sleep on weekdays,the higher the possibility of a lower ARR.Conclusion(s)1.The reference interval of PAC of Yunnan residents was: 3.16 ～ 35.28 n g/d L for males,2.55 ～ 24.59 n g/d L for women;The reference interval of DRC is: 2.18 ～ 94.54 u IU / ml in males,3.35 ～ 109.59 u IU / ml for women;The ARR reference intervals for young men and women(18-44 years)were 0.09-3.27(n g/d L)/(u IU / ml)and0.07-1.99(n g/d L)/(u IU / ml),respectively;The ARR reference interval for middle-aged men and women(45-64 years old)was 0.10-3.91(n g/d L)/(u IU / ml)and 0.07-1.99(n g/d L)/(u IU / ml),respectively;The ARR reference interval for men and women(65 years)was 0.09-4.71(n g/d L)/(u IU / ml)and 0.07-2.14(n g/d L)/(u IU / ml).2.Gender,ethnicity,urban and rural areas,hyperuricemia,marital status,smoking in the last 30 days,frequency of egg consumption,length of sleep during weekdays,and fat mass were the factors influencing PAC grade.3.Ethnic groups,urban and rural areas,smoking in the past 30 days,salt restriction,eating frequency of fish and shrimp,and sleeping time on rest days are the influencing factors of DRC grade.4.Ethnicity,age,urban and rural areas,smoking in the last 30 days,frequency of milk consumption,salt restriction,and sleeping hours on weekdays were the influencing factors of ARR grade.