Chattington P D, Anderson J V, Rees L H, Leese G P, Peters J R, Vora J P
Department of Medicine/Endocrinology, Royal Liverpool University Hospital, UK.
Diabet Med. 1998 May;15(5):375-9. doi: 10.1002/(SICI)1096-9136(199805)15:5<375::AID-DIA585>3.0.CO;2-N.
Relatively few data exist on atrial natriuretic peptide (ANP) characteristics in Type 2 diabetes mellitus (DM). Therefore, plasma immunoreactive ANP concentrations were measured before and for 4 h following the ingestion of a physiological mixed meal in 8 newly diagnosed, normotensive, normoalbuminuric, patients with Type 2 DM and 6 normotensive, non-diabetic controls. In patients with Type 2 DM, basal plasma ANP concentrations were 4.0 +/- 2.0 and not significantly changed following ingestion of the meal, with peak levels of 4.9 +/- 2.8 pmol l(-1). Non-diabetic controls had higher basal plasma ANP concentrations, 8.7 +/- 3.4 pmol l(-1) (p < 0.05), significantly increasing to a peak of 11.9 +/- 6.3 pmol l(-1) at 30 min post meal. Extracellular fluid volume (ECV) was not different between diabetic patients and controls (15877 +/- 2679 vs 13668 +/- 1792 ml3). Glomerular filtration rate (GFR) (isotopic clearance corrected for body surface area) was elevated in diabetic patients (mean +/- SD) 130 +/- 39 vs 98 +/- 10 ml min(-1), p < 0.05). For the DM subjects, basal ANP levels were negatively correlated with GFR (rs - 0.74, p < 0.05) and effective renal plasma flow (ERPF) (rs - 0.8, p < 0.05). We conclude that patients with Type 2 DM demonstrate reduced basal plasma ANP concentrations which are inversely correlated to renal function. In contrast to non-diabetic controls, ANP in Type 2 DM does not rise in response to feeding.
关于2型糖尿病（DM）患者心房利钠肽（ANP）特征的数据相对较少。因此，我们对8例新诊断的、血压正常、尿白蛋白正常的2型糖尿病患者和6例血压正常的非糖尿病对照者在摄入生理性混合餐后0小时及4小时内的血浆免疫反应性ANP浓度进行了测定。2型糖尿病患者的基础血浆ANP浓度为4.0±2.0，餐后无显著变化，峰值水平为4.9±2.8 pmol l⁻¹。非糖尿病对照者的基础血浆ANP浓度较高，为8.7±3.4 pmol l⁻¹（p<0.05），餐后30分钟显著升高至峰值11.9±6.3 pmol l⁻¹。糖尿病患者和对照者的细胞外液量（ECV）无差异（15877±2679 vs 13668±1792 ml³）。糖尿病患者的肾小球滤过率（GFR）（经体表面积校正的同位素清除率）升高（平均值±标准差），为130±39 vs 98±10 ml min⁻¹，p<0.05。对于糖尿病受试者，基础ANP水平与GFR（rs - 0.74，p<0.05）和有效肾血浆流量（ERPF）（rs - 0.8，p<0.05）呈负相关。我们得出结论，2型糖尿病患者的基础血浆ANP浓度降低，且与肾功能呈负相关。与非糖尿病对照者不同，2型糖尿病患者的ANP在进食后不升高。
