Low plasma concentrations of atrial natriuretic peptide in untreated hypothyroid patients

Widecka, Krystyna; Goździk, Jolanta; Dutkiewicz, Tomasz; Mamos, E; Czekalski, S

doi:10.1111/j.1365-2796.1990.tb00190.x

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…The finding that hypothyroid patients in our study did not show lower plasma ANH levels, such as observed in previous studies (15,16), may be related to the degree of the disease, which in our patients was mild (8). How¬ ever, in other reports plasma ANH values in hypothyroid patients did not differ from normals (10) or actually increased (9).…”

Section: Discussionsupporting

confidence: 78%

Thyroid hormones and atrial natriuretic hormone secretion: study in hyper- and hypothyroid patients

Rolandi

Santaniello²,

Bagnasco³

et al. 1992

Acta Endocrinologica

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Plasma atrial natriuretic hormone (ANH) values were evaluated in 28 hyperthyroid patients and in 11 hypothyroid patients and compared with 20 healthy subjects. In hyperthyroid patients plasma ANH basal levels were significantly (p<0.01) higher (14.2 \ m=+-\ 1.6 pmol/l) than in controls (7.8 \m=+-\0.4pmol/l) and in hypothyroid patients (6.4 \m=+-\0.3pmol/l). No significant differences were found between controls and hypothyroid patients. The propranolol-induced decrease in heart rate in hyperthyroid patients did not significantly affect the plasma ANH values. Conversely, after the methimazole-induced euthyroidism a return within the normal range of ANH values was observed. The thyroxine replacement in hypothyroid patients determined a small but significant (p<0.05) increase in plasma ANH values. Observed data suggest that in humans thyroid hormones may influence plasma ANH concentrations independently of their effect on heart rate. Ermanno Rolandi, Via Montani 32/6,

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Section: Discussionsupporting

confidence: 78%

Thyroid hormones and atrial natriuretic hormone secretion: study in hyper- and hypothyroid patients

Rolandi

Santaniello²,

Bagnasco³

et al. 1992

Acta Endocrinologica

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“…The principal cause of the discrepancies may be differences in the severity of the hypothyroidism, with significant differences only in the patients with serious deficit, as suggested by Kohno et al (1987). The duration of the hypothyroidism could also influence the plasma ANH levels of these patients, although Widecka et al (1990) found differences after only a short period of levothyroxine withdrawal. In our study, as in all those in which the hypothyroid patients have been diagnosed recently and have not received treatment, the real duration of the disease is unknown.…”

Section: Discussionmentioning

confidence: 69%

“…In patients with hypothyroidism, plasma ANH concentrations have been reported to be low (Kohno et al 1987, Zimmerman et al 1987, Woolf & Moult 1988, Widecka et al 1990, Barna et al 1994, Ota et al 1994 or normal (Ladenson et al 1987, Rolandi et al 1992. After thyroid replacement these concentrations have increased in some reports (Kohno et al 1987, Zimmerman et al 1987, Woolf & Moult 1988, Rolandi et al 1992, Bernstein et al 1997 but not in others (Weissel et al 1986, Ladenson et al 1987.…”

Section: Discussionmentioning

confidence: 99%

“…However, more recently, plasma AVP has been found to be normal or low in hypothyroid patients (Iwasaki et al 1990, Ota et al 1994. In addition, low plasma levels of atrial natriuretic hormone (ANH) have been found in some studies (Kohno et al 1987, Zimmerman et al 1987, Woolf & Moult 1988, Vesely et al 1989, Widecka et al 1990, Barna et al 1994, Ota et al 1994. This decrease could influence the sodium and water regulation of patients with hypothyroidism, although its exact contribution remains undefined.…”

Section: Introductionmentioning

confidence: 99%

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Water metabolism disturbances at different stages of primary thyroid failure

Villabona¹,

Rosel²,

Navarro³

et al. 2001

Journal of Endocrinology

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The aim of the present study was to study salt and water metabolism in thyroid deficiency.We performed an oral water loading test (OWL) and a hypertonic 5% saline infusion test (HSI) in 16 patients with overt primary hypothyroidism before replacement treatment (PRE group) and after, in eight patients with subclinical hypothyroidism (SUB group) and in 16 normal individuals (CG group).In the PRE group, a lower free water clearance was detected in the OWL (P<0·022), with lower plasma osmolality (OWL: P<0·005; HSI: P<0·001) and arginine vasopressin (AVP) (OWL: P<0·001; HSI: P<0·001) than the CG group, across both tests; they normalized with the replacement treatment. The same plasma abnormalities were detected in the SUB group with the HSI. Although the AVP and thirst thresholds did not differ between the groups, the lag between them was lower in the PRE (4·1 3·2 mOsm/kg) and SUB group (2·6 2·1 mOsm/ kg) than in the CG group (13·3 9·2 mOsm/kg) (P<0·05). There were no differences in atrial natriuretic hormone (ANH), plasma renin activity (PRA) and plasma aldosterone among the groups.These results indicate that plasma hypo-osmolality and low levels of AVP are present in primary hypothyroidism, and indeed are already present in the subclinical phase of the disease. An overlap between the thresholds of thirst and AVP seem to play a role in these abnormalities, but ANH, PRA and plasma aldosterone do not appear to contribute.

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“…Secondly, it is possible that the release of ANP, eliciting diuresis and natriuresis, may be impaired in the hypothyroid state, thereby resulting in impairment of renal water and electrolytes excretion, irrespective of AVP release. Indeed, ANP release as well as its synthesis has been reported to be impaired in hypothyroid states [17][18][19][20]. Thirdly, the possibility is not ruled out that a decrease in plasma volume may occur in the hypothyroid state, irrespective of plasma AVP and ANP, thereby stimulating the proximal tubular reabsorption of water and sodium and causing decreased CH 2u formation.…”

Section: Discussionmentioning

confidence: 99%

Effects of an Acute Water Load on Plasma ANP and AVP, and Renal Water Handling in Hypothyroidism: Comparison of Before and After L-Thyroxine Treatment.

et al. 1994

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Abstract. To assess whether atrial natriuretic peptide (ANP) and arginine vasopressin (AVP) participate in impaired water excretion in patients with hypothyroid states (HS), an oral acute water loading (WL) test (20 ml/kg.BW/45 min) was performed before and after L-thyroxine (T4) treatment in 5 hypothyroid patients. Plasma ANP, AVP, osmolality (Posm), total protein and renal water excretion were simultaneously determined, and these data were compared to the data from five normal subjects (NS). The impaired water excretion rate in HS was entirely improved in the euthyroid states (ES) after T4 therapy for at least 7 months. Plasma ANP in HS was lower than that in NS (5.9± 0.9 vs. 16.5 ± 3.6 pmol / L, P<0.05), but increased after T4 treatment (21.2±5.7 pmol / L, P<0.05). Plasma AVP in HS (1.6± 0.5 pmol / L) showed a tendency to be lower than those in ES and NS (2.9 ± 0.4 and 2.9 ± 0.7 pmol / L), but did not respond to a fall in Posm after WL, unlike ES and NS. Significant positive correlation were noticed between Posm and plasma AVP in ES and NS, but not in HS. These results suggest that not only the impaired release and/or metabolisms of AVP and ANP, but also derangement of renal water and electrolytes handling might induce attenuation of CHZO formation in hypothyroid states.

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Low plasma concentrations of atrial natriuretic peptide in untreated hypothyroid patients

Cited by 5 publications

References 10 publications

Thyroid hormones and atrial natriuretic hormone secretion: study in hyper- and hypothyroid patients

Thyroid hormones and atrial natriuretic hormone secretion: study in hyper- and hypothyroid patients

Water metabolism disturbances at different stages of primary thyroid failure

Effects of an Acute Water Load on Plasma ANP and AVP, and Renal Water Handling in Hypothyroidism: Comparison of Before and After L-Thyroxine Treatment.

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