Impairment of antidiuretic hormone and atrial natriuretic peptide regulation in the obese woman with a swelling syndrome and an increase in capillary permeability to albumin

Abstract

OBJECTIVE: To study the regulation of antidiuretic hormone (ADH) and atrial natriuretic peptide (ANP) in obese and lean women with a swelling syndrome. PATIENTS: Thirty-four obese women and 12 lean women with a swelling syndrome and an abnormal isotopic test of capillary permeability to albumin were investigated. MEASUREMENTS: After 10 nocturnal hours of¯uid restriction, subjects were asked at 8 am to ingest a tap water load of 20 ml/kg within 10 min and to remain strictly recumbent until twelve noon on the ®rst day, and to remain standing and to walk around until twelve noon on the second day. Free water clearance and the cGMP/creatinine and albumin/ creatinine ratios were determined hourly in the morning. RESULTS: The total 4 h-urinary volume/ingested water volume ratio was signi®cantly lower on the second day both in the lean and the obese patients, the differences being slightly larger in the obese patients. The increase in free water clearance was signi®cantly less on the second day in the obese patients. The increase in cGMP/creatinine ratio was also signi®cantly lower on the second day in the obese patients. The maximum level of the urinary albumin/creatinine ratio was signi®cantly higher on the second day in the obese patients. CONCLUSION: In obese women with a swelling syndrome: (1) The higher increase in the urinary albumin excretion rate after water loading followed by a sustained upright position suggests a widespread alteration in capillary function, which is also indicated by the isotopic test of capillary permeability to albumin. (2) The water load-induced inhibition of ADH secretion and stimulation of ANP secretion or ANP activity, more defective in the upright position than in the recumbent one, is probably another major contributing factor to orthostatic oedema.

Hop (Humulus lupulus L.) extract inhibits obesity in mice fed a high-fat diet over the long term

“…De Pergola et al ( 33 ) reported that the natriuretic response in obese women was found to be reduced by the treatment with intravenous injection of ANP. Valensi et al ( 34 ) reported that the water loaded-induced inhibition of anti-diuretic hormone secretion and stimulation of ANP secretion or ANP activity was more defective in obese women with a swelling syndrome. In a preliminary experiment, the hop extract stimulated water excretion in water-loaded mice.…”

Extra cellular water and increase in capillary permeability to albumin in overweight women with swelling syndrome

“…6,7 We have recently shown that in the obese women with a swelling syndrome, but not in the lean ones, the water load-induced inhibition of antidiuretic hormone secretion and stimulation of the secretion or activity of atrial natriuretic peptide are more defective in the upright position than in the recumbent one. 10 These hormonal factors may be involved in the aggravation of oedema in the upright position in the overweight women.…”

“…6 ± 9 We have recently shown that after an oral water load, changes in antidiuretic hormone secretion and stimulation of atrial natriuretic peptide secretion or activity are abnormal in the upright position in the obese patients with a swelling syndrome. 10 Bioelectrical impedance analysis is an easy, safe and rapid method for estimating body water and its compartments. The applicability of multiple-frequency BIA was proposed in the early sixties.…”