title: Regulation of ANP secretion in insulin-dependent diabetes mellitus and the influence of autonomic neuropathy.
abstract: In order to determine the effect of diabetic autonomic neuropathy (DAN) on the atrial natriuretic peptide (ANP) response to dynamic stimuli, we studied the ANP response to 60 degrees head-up and 60 degrees leg-up tilt in diabetic subjects with (DAN + ve, n = 8) and without (DAN - ve, n = 8) evidence of autonomic neuropathy and seven matched non-diabetic controls. Mean baseline plasma ANP concentrations were similar in all three groups. Head-up tilt was associated with a fall in plasma ANP in all seven healthy controls (21.8 (16.8-30.7) to 16.8 (7.1-29.1), P = 0.06, mean (range)), seven of the eight DAN - ve (16.9 (6.5-33.7) to 8.5 (3.0-21.1), P = 0.015) and all eight DAN + ve subjects (27.3 (8.5-101.5) to 15.4 (1.0-67.6), P = 0.044). Leg-up tilt caused a rise in plasma ANP in six of the seven healthy controls (17.6 (7.5-27.9) to 22.4 (15.2-48.1), P = 0.041), six of the eight DAN - ve (12.5 (7.8-27.8) to 15.5 (7.3-31.3), P = 0.054) and seven of the eight DAN + ve subjects (18.2 (2.8-55.1) to 25.1 (4.5-92.8), P = 0.013). There was no significant difference in the fall in plasma ANP during head-up tilt or in the rise in plasma ANP during leg-up tilt between the three groups. We conclude that the regulation of ANP secretion is normal in diabetes mellitus, and is unaffected by the presence of autonomic neuropathy.
authors.affiliation: Department of Medicine, Royal Infirmary, Edinburgh U.K.
authors.forename: C J
authors.initials: CJ
authors.lastname: Thompson
authors.forename: P J
authors.initials: PJ
authors.lastname: Leslie
authors.forename: S L
authors.initials: SL
authors.lastname: Lightman
authors.forename: B F
authors.initials: BF
authors.lastname: Clarke
authors.forename: D J
authors.initials: DJ
authors.lastname: Ewing
mesh_terms: D000328:Adult; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D001341:Autonomic Nervous System / Q000473:pathology; D001786:Blood Glucose / Q000032:analysis; D001810:Blood Volume; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000378:metabolism*; D003929:Diabetic Neuropathies / Q000150:complications / Q000378:metabolism*; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration
chemical_list: D001786:Blood Glucose; D009320:Atrial Natriuretic Factor