Haditsch B, Roessler A, Hinghofer-Szalkay H G
Institute of Adaptive and Spaceflight Physiology, Graz, Austria.
Physiol Res. 2007;56(6):779-787. doi: 10.33549/physiolres.931032. Epub 2006 Nov 6.
Previous investigations revealed that most of the fluid regulating hormones showed no consistent relationship to the hypoxic diuretic response (HDR). In this study we examined if adrenomedullin (AM), a hypoxia-mediated diuretic/natriuretic peptide is connected to HDR. Thirty-three persons were examined at low altitude (LA), on the third exposure day at 3440 m (medium altitude, MA) and on the fourteenth day at 5050 m (high altitude, HA). Nocturnal diuresis rose from 460 ml [interquartile range 302 ml] at LA to 560 [660] ml at MA to 1015 [750] ml at HA (p<0.005). Sodium excretion was similar at LA and MA (41.8 [27.0] vs. 41.4 [28.4] mM) and increased to 80.2 [29.1] mM at HA (p<0.005). Urinary AM excretion was 7.9 [3.9] at LA, 7.5 [5.7] pM at MA, and increased to 10.5 [5.1] pM (p<0.05) at HA. Urinary AM excretion was correlated to diuresis (r=0.72, p<0.005) and sodium excretion (r=0.57, p<0.005). Plasma AM concentration rose from 16.4 [3.1] to 18.8 [4.9] pM/l at MA (p<0.005) and to 18.3 [4.3] pM/l at HA (p<0.005). Plasma AM concentration and urinary AM excretion were not correlated, neither were plasma AM concentration and diuresis or natriuresis. Our data suggest the involvement of increased renal AM production in the pathophysiology of high altitude fluid and sodium loss.
先前的研究表明，大多数体液调节激素与低氧利尿反应（HDR）之间没有一致的关系。在本研究中，我们检测了作为一种低氧介导的利尿/利钠肽的肾上腺髓质素（AM）是否与HDR相关。对33名受试者在低海拔（LA）、海拔3440米的第三天（中等海拔，MA）和海拔5050米的第十四天（高海拔，HA）进行了检测。夜间尿量从LA时的460毫升[四分位间距302毫升]增加到MA时的560[660]毫升，再到HA时的1015[750]毫升（p<0.005）。钠排泄量在LA和MA时相似（41.8[27.0]对41.4[28.4]毫摩尔），在HA时增加到80.2[29.1]毫摩尔（p<0.005）。尿AM排泄量在LA时为7.9[3.9]皮摩尔，在MA时为7.5[5.7]皮摩尔，在HA时增加到10.5[5.1]皮摩尔（p<0.05）。尿AM排泄量与尿量（r=0.72，p<0.005）和钠排泄量（r=0.57，p<0.005）相关。血浆AM浓度从MA时的16.4[3.1]皮摩尔/升升至18.8[4.9]皮摩尔/升（p<0.005），在HA时升至18.3[4.3]皮摩尔/升（p<0.005）。血浆AM浓度与尿AM排泄量不相关，血浆AM浓度与尿量或尿钠排泄量也不相关。我们的数据表明，肾脏AM生成增加参与了高海拔地区体液和钠丢失的病理生理过程。
