title: Body sodium, atrial natriuretic peptide and blood pressure in diabetes mellitus.
abstract: Diabetes mellitus (DM) is frequently associated with hypertension for which an independent pathomechanism has been suggested. We studied 26 patients with insulin-dependent (IDDM) and 18 patients with non-insulin-dependent (NIDDM) uncomplicated DM; all patients were in metabolic balance and none of them had hypertension. Exchangeable body sodium (NaE was estimated by isotope dilution, using appr. 1.1 Mbq 24NA. In a subset of 8 IDDM and 8 NIDDM patients atrial natriuretic peptide (ANP) plasma concentration was determined prior to and after the infusion of 2000 ml physiological saline over 2 hr. NaE was significantly increased both in IDDM and NIDDM patients (104.4 +/- 11.4% and 109.9 +/- 8.0% of the normal value for healthy subjects of identical body surface area; p < 0.05 and < 0.001 resp.). Mean blood pressure (MBP) correlated significantly with NaE in both groups (r = 0.364 and r = 0.520; p < 0.05 and < 0.025, resp.) but not in healthy control subjects (r = 0.112; N.S.). Resting ANP levels were not significantly different in IDDM (34.9 +/- 11.3 pg/ml), NIDDM (42.6 +/- 11.7 pg/ml) or control subjects (40.9 +/- 17.2 pg/ml) however the infusion of saline resulted in a significantly greater increase of plasma ANP in the NIDDM patients (to 82.9 +/- 43.2 pg/ml; P < 0.01) than in the controls (55.6 +/- 23.7 pg/ml; P < 0.01) which was associated with a significantly less increase in sodium excretion (UNAV) in the NIDDM patients (+86% vs. 3170%; P < 0.02) indicating down-regulation of ANP receptors in the kidney of NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: 1st Dept. of Internal Medicine, Semmelweis University, Budapest.
authors.forename: R
authors.initials: R
authors.lastname: De Châtel
authors.forename: M
authors.initials: M
authors.lastname: Tóth
authors.forename: I
authors.initials: I
authors.lastname: Barna
authors.forename: A
authors.initials: A
authors.lastname: Tislér
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D001794:Blood Pressure; D001835:Body Weight; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000097:blood / Q000378:metabolism*
chemical_list: D009320:Atrial Natriuretic Factor; D012964:Sodium