Department of Endocrinology and Metabolism, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Obes Facts. 2018;11(1):56-66. doi: 10.1159/000486513. Epub 2018 Feb 14.
The sodium-sparing effect of insulin leads to increase in total sodium pool of the body which is a chronic stimulus for atrial natriuretic peptide (ANP). In our study we aimed to determine the relationship between ANP and microvascular complications of diabetes.
60 patients, 30-70 years old, with the diagnosis of type 2 diabetes mellitus (DM) are enrolled into the study. Patients with a chronic disease other than DM are excluded. Blood samples for routine biochemical tests are taken after at least 12 h fasting at 8-9 am. Blood samples for glucose and insulin levels are taken 2 h after a standard meal. Blood tubes with EDTA are used for ANP levels. The microvascular complications of the patients are evaluated.
32 of the patients had microvascular complications. Age, BMI, waist and hip circumferences, and ANP levels were significantly higher in the group with microvascular complications. There were no significant differences in waist-to-hip ratio, blood glucose, HbA1c, fasting insulin, postprandial insulin, fasting HOMA, postprandial HOMA as well as sodium, potassium, magnesium, calcium and lipid levels between the two groups. When the relationship between ANP and obesity, retinopathy, neuropathy, nephropathy, diabetes time, HbA1c, or sex are evaluated separately, the only significant parameters related to ANP were obesity and retinopathy.
In our study we have found that there was a significant relationship between ANP levels and microvascular complications of diabetes. Future studies are needed to show if ANP is the stimulus of microvascular complication development/progression or only an epiphenomenon.
胰岛素的保钠作用会导致体内总钠池增加,这是心房利钠肽 (ANP) 的慢性刺激因素。在我们的研究中,我们旨在确定 ANP 与糖尿病微血管并发症之间的关系。
纳入 60 名年龄在 30-70 岁之间、诊断为 2 型糖尿病 (DM) 的患者。排除患有除 DM 以外的慢性疾病的患者。至少禁食 12 小时后,于上午 8-9 点采集血液样本进行常规生化检查。标准餐后 2 小时采集血糖和胰岛素水平的血液样本。使用 EDTA 管采集 ANP 水平的血液样本。评估患者的微血管并发症。
32 名患者存在微血管并发症。有微血管并发症的患者的年龄、BMI、腰围和臀围以及 ANP 水平显著更高。两组之间的腰臀比、血糖、HbA1c、空腹胰岛素、餐后胰岛素、空腹 HOMA、餐后 HOMA 以及钠、钾、镁、钙和血脂水平没有显著差异。当分别评估 ANP 与肥胖、视网膜病变、神经病变、肾病、糖尿病病程、HbA1c 或性别之间的关系时,与 ANP 相关的唯一显著参数是肥胖和视网膜病变。
在我们的研究中,我们发现 ANP 水平与糖尿病的微血管并发症之间存在显著关系。未来的研究需要表明 ANP 是微血管并发症发展/进展的刺激因素,还是仅仅是一种伴随现象。