Kahn J K, Grekin R J, Shenker Y, Vinik A I
Regul Pept. 1986 Nov;15(4):323-32. doi: 10.1016/0167-0115(86)90162-x.
In order to determine whether atrial natriuretic hormone (ANH) secretion is altered in diabetic patients with autonomic neuropathy, plasma immunoreactive ANH (IR-ANH) levels were measured in 23 patients with insulin-dependent diabetes mellitus, 12 of whom had definite cardiac autonomic neuropathy determined by noninvasive maneuvers. Levels were also measured in 31 healthy control subjects. Whereas only one of the 11 diabetics without cardiac autonomic neuropathy had elevated IR-ANH levels, four of the 12 diabetics with cardiac autonomic neuropathy had elevated IR-ANH levels (P = 0.03 compared to control subjects). 24-h urinary sodium excetion was not different among the groups. There was no significant correlation between IR-ANH levels and diabetes control and any of the parameters of autonomic nervous system activity nor between IR-ANH levels and plasma norepinephrine or epinephrine levels. Furthermore, no relationship was observed in the diabetic subjects between IR-ANH levels and left ventricular ejection fraction determined by radionuclide ventriculography. Thus, elevated IR-ANH levels occur with greater frequency in diabetic patients with autonomic neuropathy. These elevations do not appear to be due to alterations in dietary sodium intake or left ventricular dysfunction.
为了确定自主神经病变的糖尿病患者心房利钠激素（ANH）分泌是否改变，我们检测了23例胰岛素依赖型糖尿病患者的血浆免疫反应性ANH（IR-ANH）水平，其中12例经无创检查确诊有明确的心脏自主神经病变。同时也检测了31名健康对照者的IR-ANH水平。在11例无心脏自主神经病变的糖尿病患者中，只有1例IR-ANH水平升高，而在12例有心脏自主神经病变的糖尿病患者中，有4例IR-ANH水平升高（与对照者相比，P = 0.03）。各组间24小时尿钠排泄无差异。IR-ANH水平与糖尿病控制情况、自主神经系统活动的任何参数之间，以及IR-ANH水平与血浆去甲肾上腺素或肾上腺素水平之间均无显著相关性。此外，在糖尿病患者中，未观察到IR-ANH水平与放射性核素心室造影测定的左心室射血分数之间存在关联。因此，自主神经病变的糖尿病患者中IR-ANH水平升高更为常见。这些升高似乎并非由于饮食中钠摄入量的改变或左心室功能障碍所致。
