Cavan D, O'Donnell M J, Parkes A, Lewis H, Lawson N, Chapman J, Barnett A H
Department of Medicine, University of Birmingham, UK.
J Hum Hypertens. 1991 Feb;5(1):21-6.
Eight male normoproteinuric Type I (insulin dependent) diabetic patients and eight age- and sex-matched non-diabetic control subjects were studied for their response to exercise. Systolic blood pressure showed an exaggerated response to exercise in the diabetic group (median 123, range 98-151 mmHg, pre-exercise vs. 187, 163-217 mmHg, immediately post exercise P less than 0.01) compared to the control group (median 112 (100-145) pre-exercise, 153 (138-178) post exercise). Resting noradrenaline levels were lower in the diabetic (D) compared with the control (C) group (D: 1.66, 0.55-3.92 nmol/l vs. C: 2.96, 2.04-4.49 nmol/l, P less than 0.02). Levels rose during exercise by 79% (25-307%) and 43% (4-90%) respectively (NS). Resting urinary sodium was raised in the diabetic group and fell during exercise (P less than 0.05) (D: 146, 74-244 mumol/min, C: 108.5 (83.4-151.0) pre-exercise vs. D: 73, 48-264 mumol/min, C: 81.7 (23.0-92.0) post exercise). Resting atrial natriuretic peptide levels were lower in the diabetic group (D: 10.1, 4.3-16.9 pmol/l vs. C: 16.0, 9.5-22.9 pmol/l, P less than 0.02) and levels rose significantly in both groups during exercise (D: 25.9, 5.2-38.9 pmol/l vs. C: 28.6, 17.3-47.2 pmol/l, P less than 0.05). We conclude that exercise provokes an exaggerated rise in systolic blood pressure and decrease in urinary sodium excretion in normoalbuminuric diabetic patients. These findings may reflect increased sensitivity to the renin-angiotensin-aldosterone system. Reduced atrial natriuretic peptide levels may stimulate sodium retention and increased blood pressure in early diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)
对8名I型（胰岛素依赖型）正常蛋白尿男性糖尿病患者和8名年龄及性别匹配的非糖尿病对照受试者进行了运动反应研究。与对照组（运动前中位数112（100 - 145），运动后153（138 - 178））相比，糖尿病组收缩压对运动的反应更为强烈（运动前中位数123，范围98 - 151 mmHg，运动后立即升至187，163 - 217 mmHg，P < 0.01）。糖尿病（D）组静息去甲肾上腺素水平低于对照组（C）组（D：1.66，0.55 - 3.92 nmol/l vs. C：2.96，2.04 - 4.49 nmol/l，P < 0.02）。运动期间，两组水平分别升高79%（25 - 307%）和43%（4 - 90%）（无显著性差异）。糖尿病组静息尿钠升高，运动期间下降（P < 0.05）（D：146，74 - 244 μmol/min，C：运动前108.5（83.4 - 151.0），运动后D：73，48 - 264 μmol/min，C：81.7（23.0 - 92.0））。糖尿病组静息心房利钠肽水平较低（D：10.1，4.3 - 16.9 pmol/l vs. C：16.0，9.5 - 22.9 pmol/l，P < 0.02），运动期间两组水平均显著升高（D：25.9，5.2 - 38.9 pmol/l vs. C：28.6，17.3 - 47.2 pmol/l，P < 0.05）。我们得出结论，运动可使正常蛋白尿糖尿病患者的收缩压过度升高，尿钠排泄减少。这些发现可能反映了对肾素 - 血管紧张素 - 醛固酮系统的敏感性增加。心房利钠肽水平降低可能会在糖尿病早期刺激钠潴留和血压升高。（摘要截短于250字）
