Atrial natriuretic peptide in Type 2 diabetes mellitus: response to a physiological mixed meal and relationship to renal function
✍ Scribed by Chattington, P.D.; Anderson, J.V.; Rees, L.H.; Leese, G.P.; Peters, J.R.; Vora, J.P.
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 51 KB
- Volume
- 15
- Category
- Article
- ISSN
- 0742-3071
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✦ Synopsis
Relatively few data exist on atrial natriuretic peptide (ANP) characteristics in Type 2 diabetes mellitus (DM). Therefore, plasma immunoreactive ANP concentrations were measured before and for 4 h following the ingestion of a physiological mixed meal in 8 newly diagnosed, normotensive, normoalbuminuric, patients with Type 2 DM and 6 normotensive, non-diabetic controls. In patients with Type 2 DM, basal plasma ANP concentrations were 4.0 ± 2.0 and not significantly changed following ingestion of the meal, with peak levels of 4.9 ± 2.8 pmol l -1 . Non-diabetic controls had higher basal plasma ANP concentrations, 8.7 ± 3.4 pmol l -1 (p Ͻ Ͻ Ͻ 0.05), significantly increasing to a peak of 11.9 ± 6.3 pmol l -1 at 30 min post meal. Extracellular fluid volume (ECV) was not different between diabetic patients and controls (15 877 ± 2679 vs 13 668 ± 1792 ml 3 ). Glomerular filtration rate (GFR) (isotopic clearance corrected for body surface area) was elevated in diabetic patients (mean ± SD) 130 ± 39 vs 98 ± 10 ml min -1 , p Ͻ Ͻ Ͻ 0.05). For the DM subjects, basal ANP levels were negatively correlated with GFR (r s -0.74, p Ͻ Ͻ Ͻ 0.05) and effective renal plasma flow (ERPF) (r s -0.8, p Ͻ Ͻ Ͻ 0.05). We conclude that patients with Type 2 DM demonstrate reduced basal plasma ANP concentrations which are inversely correlated to renal function. In contrast to non-diabetic controls, ANP in Type 2 DM does not rise in response to feeding.