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

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.

Atrial natriuretic peptide increases urinary albumin excretion in people with normoalbuminuric type-2 diabetes

“…Although some studies have demonstrated that plasma levels of ANP are normal in patients with type-2 diabetes [24], plasma concentrations of ANP have been shown to be elevated in the subgroup of patients with type-2 diabetes and microalbuminuria [25]. Our data would support the hypothesis that the elevated plasma ANP concentrations typically seen in patients with type-2 diabetes and hypertension, chronic hyperglycaemia and cardiac failure, may contribute to the development of microalbuminuria.…”

Association of Plasma Natriuretic Peptide Levels With Metabolic Risk Factors in Ambulatory Individuals

“…6,21,22 Nonetheless, few studies have examined the relations of natriuretic peptide levels to other metabolic risk factors. 7,8 In smaller studies, inconsistent associations have been noted between plasma natriuretic peptides and glycemic status 9,23,24 or plasma lipids. 8 Olsen and colleagues 7 reported results of the only other large-scale investigation of plasma natriuretic peptide levels and metabolic risk factors.…”

Impact of Obesity on Plasma Natriuretic Peptide Levels

“…Hypertension seems to elevate circulating natriuretic peptide levels, 7,8 whereas the effect of diabetes is less clear. 9,10 The availability of routine plasma natriuretic peptide measurements on more than 3000 individuals in the Framingham Heart Study made it possible to investigate the impact of obesity on natriuretic peptide levels and to distinguish this impact from that of hypertension, diabetes, and other characteristics.…”