Changes of angiotensin and aldosterone levels and renin activity in patients with occupational hand-arm vibration disease

Background Patients with occupational hand-arm vibration disease (OHAVD) have hand peripheral circulation disorders and/or arm nerve dysfunction. The renin-angiotensin-aldosterone system is a pressure-regulating system in human body, which can cause contraction of vascular smooth muscles. Angiotensin (Ang) in this system can not only cause vasoconstriction, but also produce proinflammatory effects, inducing apoptosis of vascular endothelial cells and damage to vascular tissues.

Objective This study is conducted to investigate whether the renin-angiotensin-aldosterone system is involved in developing OHAVD-related vascular injury.

Methods Using cluster sampling, 90 patients with OHAVD hospitalized in Guangdong Province Hospital for Occupational Disease Prevention and Treatment from May 2016 to May 2019 were selected as the OHAVD group, and the patients were divided into vibratory white finger (VWF) and non-VWF subgroups based on VWF occurrence before the OHAVD diagnosis. Another 70 office clerks without hand-transmitted vibration exposure history and of similar seniority and age as the OHAVD group from the same company were selected as the control group. Ang Ⅰ (37℃), Ang Ⅰ (4℃), Ang II, and aldosterone (ALD) levels, as well as renin activity (PRA) and aldosterone-renin activity ratio (ARR) in morning fasting venous plasma of all participants were measured. The differences in above indicators and their abnormal rates were compared.

Results The AngⅠ (37℃) level, AngⅠ(4℃) level, PRA, ALD level, and ARR in M (Min, Max) in the OHAVD group were 2.29 (0.55, 8.30) μg·L^-1, 0.68 (0.25, 2.07) μg·L^-1, 1.63 (0.26, 6.58) μg·L^-1·h^-1, 122.01 (63.45, 620.96) ng·L^-1, and 7.88 (2.12, 171.48), respectively, and the Ang Ⅱ level in (x±s) was (56.56±13.58) ng·L^-1. The ALD level in the OHAVD group was lower than that in the control group137.59 (60.97, 651.17) ng·L^-1 (P < 0.05), and the differences in the other indicators were not statistically significant between the two grpups (P>0.05). There were no differences in all indicators between the two subgroups (P>0.05). There were also no differences in the abnormal rates of above indicators between the two groups and between the two subgroups (P>0.05).

Conclusion No evidence is found in the study that the renin-angiotensin-aldosterone system is involved in vibrational vascular injury of OHAVD.