Sympathetic Nervous System Activity in Patients with Metabolic Syndrome, Type 2 Diabetes Mellitus and Chronic Kidney Disease. Role of Renalase and Alpha Amylase

Aim: To evaluate serum renalase and salivary alpha amylase concentrations and their relationship with plasma catecholamine levels in patients with Metabolic Syndrome (MS), Type 2 Diabetes Mellitus (T2DM), and End-Stage Renal Disease (ESRD). Method: In cross-sectional study 163 patients were enrolled; 43 patients with MS, 93 withT2DM, 13 with ESRD, and 14 healthy subjects (control group). All patients had their ascription to the UMAA/UMF No. 75, in Morelia, Michoacan, Mexico. Glucose, creatinine, cholesterol, triglycerides, HDL, and renalase were measurement in serum, and Dopamine (DA), Epinephrine (E) and Norepinephrine (NE) in plasma. An aliquot of saliva was collected for alpha amylase determination. Results: High plasma concentrations of DA, E and NE (p<0.0001) was founded in T2DM and ESRD patients. Renalase was lower in ESRD compared to MS and T2DM patients (p<0.0001). High concentrations of alpha amylase were found in MS, T2DM, and ESRD patients in comparison with control group (p<0.0001). Catecholamines correlated positively with alpha amylase and diabetes evolution. Conclusion: Sympathetic hyperactivity in MS, T2DM and ESRD patients was founded. Renalase could be proposed as biomarker of renal function and salivary alpha amylase as sympathetic hyperactivity. Additional studies are required to evaluate the pathophysiological mechanisms involved of SNS in CKD development.