Melander Olle, Frandsen Erik, Groop Leif, Hulthén U Lennart
Department of Endocrinology, Lund University, Malmö, Sweden.
Hypertension. 2002 May;39(5):996-9. doi: 10.1161/01.hyp.0000017552.91014.2a.
The aim of the present study was to investigate whether plasma concentration of proANP(1-30), the N-terminal fragment of the atrial natriuretic peptide prohormone, or 24-hour urinary excretion of urodilatin reflects the degree of salt sensitivity in hypertension-prone individuals. Plasma concentration of proANP(1-30) and urinary urodilatin excretion were determined at baseline, after 1 week on a low-salt diet (10 mmol/d) and after another week on a high-salt diet (240 mmol/d) in 30 healthy subjects with heredity for hypertension. Salt sensitivity was defined as the difference between mean arterial blood pressure after the high-salt diet and the mean arterial blood pressure after the low-salt diet. High- versus low-salt intake increased proANP(1-30) (668+/-330 versus 358+/-150 pmol/L; P<0.00001) and urodilatin (18.7+/-5.2 versus 16.0+/-8.3 pmol/24 h; P<0.05). ProANP(1-30) correlated with salt sensitivity at baseline (r=0.76, P<0.000001), after the low- (r=0.80, P<0.0000001) and high-salt diets (r=0.85, P<0.00000001). The increase in proANP(1-30) induced by changing from the low- to the high-salt diet was also directly related to salt sensitivity (r=0.78, P<0.000001). ProANP(1-30) was not related to urinary sodium excretion. Neither urodilatin nor the sodium-induced change in urodilatin correlated with salt sensitivity. However, urodilatin was related to the urinary sodium excretion at baseline (r=0.58, P<0.01) and after the high-salt diet (r=0.62, P<0.001). In conclusion, the close correlations between proANP(1-30) and salt sensitivity suggest that proANP(1-30) may serve as a marker for salt sensitivity and could be useful in identifying subjects who would benefit from dietary salt restriction to prevent development of hypertension.
本研究旨在探究心房利钠肽原激素的N端片段proANP(1 - 30)的血浆浓度或尿舒张素的24小时尿排泄量是否反映高血压易感个体的盐敏感性程度。在30名有高血压遗传倾向的健康受试者中，于基线时、低钠饮食（10 mmol/d）1周后以及高钠饮食（240 mmol/d）另一周后，分别测定了proANP(1 - 30)的血浆浓度和尿舒张素排泄量。盐敏感性定义为高盐饮食后的平均动脉血压与低盐饮食后的平均动脉血压之差。高盐摄入与低盐摄入相比，可使proANP(1 - 30)升高（668±330对358±150 pmol/L；P<0.00001），尿舒张素也升高（18.7±5.2对16.0±8.3 pmol/24 h；P<0.05）。proANP(1 - 30)在基线时（r = 0.76，P<0.000001）、低盐饮食后（r = 0.80，P<0.0000001）和高盐饮食后（r = 0.85，P<0.00000001）均与盐敏感性相关。从低盐饮食改为高盐饮食所诱导的proANP(1 - 30)升高也与盐敏感性直接相关（r = 0.78，P<0.000001）。proANP(1 - 30)与尿钠排泄无关。尿舒张素及其钠诱导的变化均与盐敏感性无关。然而，尿舒张素在基线时（r = 0.58，P<0.01）和高盐饮食后（r = 0.62，P<0.001）与尿钠排泄相关。总之，proANP(1 - 30)与盐敏感性之间的密切相关性表明，proANP(1 - 30)可能作为盐敏感性的标志物，有助于识别那些可从饮食限盐中受益以预防高血压发生的个体。
