Atrial natriuretic peptide in type 2 diabetes mellitus: response to a physiological mixed meal and relationship to renal function

Diabet Med. 1998 May;15(5):375-9. doi: 10.1002/(SICI)1096-9136(199805)15:5<375::AID-DIA585>3.0.CO;2-N.

Abstract

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 < 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 (15877 +/- 2679 vs 13668 +/- 1792 ml3). 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 < 0.05). For the DM subjects, basal ANP levels were negatively correlated with GFR (rs - 0.74, p < 0.05) and effective renal plasma flow (ERPF) (rs - 0.8, p < 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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Atrial Natriuretic Factor / blood*
  • Atrial Natriuretic Factor / drug effects*
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Dietary Carbohydrates / administration & dosage
  • Dietary Carbohydrates / pharmacology
  • Dietary Fats / administration & dosage
  • Dietary Fats / pharmacology
  • Dietary Proteins / administration & dosage
  • Dietary Proteins / pharmacology
  • Fasting
  • Food, Formulated*
  • Glomerular Filtration Rate / drug effects
  • Glycated Hemoglobin / drug effects
  • Glycated Hemoglobin / metabolism
  • Hematocrit
  • Humans
  • Insulin / blood
  • Kidney / drug effects
  • Kidney / physiopathology
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Renal Plasma Flow, Effective / drug effects
  • Urea / blood

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fats
  • Dietary Proteins
  • Glycated Hemoglobin A
  • Insulin
  • Atrial Natriuretic Factor
  • Urea