title: Increased plasma atrial natriuretic factor and reduced plasma renin in patients with poorly controlled diabetes mellitus.
abstract: 1. To investigate atrial natriuretic factor (ANF) and its relationship to the renin system in diabetes, we measured plasma immunoreactive ANF and plasma renin activity (PRA) in 27 non-ketotic diabetic patients without evidence of cardiac or overt renal disease, and compared them with 26 age- and sex-matched normal subjects. 2. Diabetic patients were divided prospectively into poor (PGC, n = 14) or moderate (MGC, n = 13) glycaemic control depending on their concurrent plasma glycohaemoglobin (HbA1) levels (greater than 9% or less than 9%, respectively). Plasma ANF was elevated in PGC diabetic patients (15.7 +/- 1.8 fmol/ml, mean +/- SEM) compared with MGC diabetics (9.9 +/- 0.8 fmol/ml, P less than 0.001) and normal subjects (10.1 +/- 1.3 fmol/ml, P less than 0.05). 3. In contrast, PRA was lower in the PGC diabetic patients (1.3 +/- 0.3 pmol of angiotensin 1 h-1 ml-1) compared with the other groups (2.5 +/- 0.5 and 2.1 +/- 0.2 pmol of angiotensin I h-1 ml-1, P less than 0.05). Diabetic groups had proportionally more patients with high prorenin values (over 30 ng h-1 ml-1) than the normal group, but there was no difference between the diabetic groups. 4. Among the diabetic patients, ANF was directly related to HbA1 (r = 0.49, P less than 0.005) and urinary albumin excretion (r = 0.40, P less than 0.02), and was inversely related to PRA (r = 0.36, P less than 0.04) and plasma creatinine (r = -0.42, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Cardiovascular Center, New York Hospital-Cornell Medical Center, New York.
authors.forename: G M
authors.initials: GM
authors.lastname: Bell
authors.forename: R K
authors.initials: RK
authors.lastname: Bernstein
authors.forename: J H
authors.initials: JH
authors.lastname: Laragh
authors.forename: S A
authors.initials: SA
authors.lastname: Atlas
authors.forename: G D
authors.initials: GD
authors.lastname: James
authors.forename: M S
authors.initials: MS
authors.lastname: Pecker
authors.forename: J E
authors.initials: JE
authors.lastname: Sealey
mesh_terms: D009320:Atrial Natriuretic Factor / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood*; D004792:Enzyme Precursors / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*
chemical_list: D004792:Enzyme Precursors; D009320:Atrial Natriuretic Factor; D012083:Renin