Dr. Joshua J. Joseph (above, right) examines a patient with diabetes. Joseph led a study at The Ohio State University Wexner Medical Center that found increased levels of a hormone associated with hypertension may play a significant role in the development of Type 2 diabetes.
He also found that the risk is nearly three times greater for African-Americans with high levels of the hormone.
Researchers followed 1,600 people across diverse populations for a period of 10 years as part of the Multi-Ethnic Study of Atherosclerosis.
They found that the risk of developing Type 2 diabetes more than doubled for people who had higher levels of the hormone, aldosterone, compared to participants with lower levels of the hormone.
The effect also varied based on ethnicity: African Americans with high aldosterone levels had almost a three-fold increased risk. Chinese Americans with high aldosterone were 10 times more likely to develop diabetes.
“Aldosterone is produced by the adrenal gland,” explains Joseph. “We’ve known for some time that it increases blood pressure. We’ve recently learned it also increases insulin resistance in muscle and impairs insulin secretion from the pancreas. Both actions increase a person’s risk of developing Type 2 diabetes, but the question was — how much?” he says.
Joseph reveals he looked into this particular area for his father, who had high levels of aldosterone that contributed to his hypertension. Joseph thought it also might be linked to his diabetes. “As my career progressed, I had the opportunity to research it, and we did find a link to diabetes,” he says.
The question that remains for researchers to explore is why the risk differs with various ethnic groups.
Joseph explains it could be genetics or other differences that warrant further study. Next, he plans to lead a clinical trial at Ohio State Wexner Medical Center to evaluate the role of aldosterone in glucose metabolism.
African American participants who have prediabetes will take medication to lower their aldosterone levels. Researchers will study the impact on blood glucose and insulin in those individuals.
“We know there’s a relationship between aldosterone and Type 2 diabetes. Now we need to determine thresholds that will guide clinical care and the best medication for treatment,” Joseph indicates. The trial will start enrolling patients later this year.
Research published in the Journal of the American Heart Association.
Image credit: The Ohio State University Wexner Medical Center.