J. Endocrinol. Invest. 25: 309-314, 2002
309
ABSTRACT. The renin-angiotensin-aldosterone
system (RAAS) plays a well-recognized role in the
regulation of BP and in salt and water balance.
Since hypertension affects a considerable pro-
portion of obese patients, circulating RAAS has
been studied in obese subjects with and without
hypertension, albeit with conflicting results. Fur-
thermore, attention has recently focused on the
expression of the components of the Renin-an-
giotensin system (RAS) in some organs, includ-
ing adipose tissue where it seems to be involved
in the regulation of growth and differentiation.
The aim of our study was to investigate circulat-
ing RAAS and adipose tissue RAS in obese pa-
tients with and without hypertension and in
matched controls. PRA, and plasma and urinary
aldosterone levels were measured in 35 obese,
30 hypertensive obese patients and in 20 con-
trols. In addition, the expression of angioten-
sinogen (AGT) and angiotensin II type 1 recep-
tor (AT1) genes was studied in sc adipose tissue
from 8 obese, 6 hypertensive obese and 6
healthy subjects. As previously demonstrated in
other studies, there were no significant differ-
ences in the levels of circulating RAAS compo-
nents in the 3 groups. As regards local RAS, in-
terestingly, we found that AT1 gene was signif-
icantly more expressed in sc adipose tissue from
obese patients with hypertension than in those
without hypertension and controls. By contrast,
AGT levels were similar in the 3 groups. Our da-
ta do not support the hypothesis of an involve-
ment of circulating RAAS in the development of
obesity-related hypertension. On the other hand,
local RAS seems to be differently regulated in sc
adipose tissue from obese patients with hyper-
tension with respect to normotensive obese pa-
tients and controls.
(J. Endocrinol. Invest. 25: 309-314, 2002)
©
2002, Editrice Kurtis
INTRODUCTION
The association between obesity and hypertension
is well known, albeit the causal relationship for their
coexistence is still unclear (1).
The circulating renin-angiotensin-aldosterone system
(RAAS) plays an important role in the regulation of
BP and in salt and water balance, and plasma an-
giotensinogen (p-AGT) has been shown to positive-
ly correlate both with BP (2) and BMI in different hu-
man populations (3-5). Because of this, several stud-
ies have focused on this system in the obese, al-
though results have sometimes been controversial.
In the last few years, adipose tissue has been rec-
ognized as a real endocrine organ expressing and
secreting many factors acting with an autocrine,
paracrine and endocrine function at different lev-
els (6). In particular, recent studies suggest the ex-
istence in adipose tissue, as in a number of other
organs, of a functional local renin-angiotensin sys-
tem (RAS), where it seems to be implicated in both
physiology and pathophysiology (7, 8).
Whereas a considerable body of data is available
regarding the expression of the RAS components
in human adipose tissue (9), no studies have been
performed, to our knowledge, on the expression of
the RAS components in the adipose tissue of obese
patients with and without hypertension.
Key-words: Obesity, hypertension, adipose tissue, angiotensinogen, an-
giotensin II receptors.
Correspondence: Dr. Emanuela Faloia, Divisione di Endocrinologia, Uni-
versità di Ancona, Azienda Ospedaliera “Umberto I”, 60020 Torrette,
Ancona, Italy.
E-mail: e.faloia@ao-umbertoprimo.marche.it
Accepted September 20, 2001.
Comparison of circulating and local adipose tissue renin-
angiotensin system in normotensive and
hypertensive obese subjects
E. Faloia*, C. Gatti*, M.A. Camilloni*, B. Mariniello*, C. Sardu*, G.G.M. Garrapa*,
F. Mantero**, and G. Giacchetti*
*Division of Endocrinology, Department of Internal Medicine, University of Ancona, Ancona, **Division
of Endocrinology, Department of Medical Sciences, University of Padova, Padova, Italy