ATRIAL-NATRIURETIC-PEPTIDE IN TYPE-2 DIABETES-MELLITUS - RESPONSE TO A PHYSIOLOGICAL MIXED MEAL AND RELATIONSHIP TO RENAL-FUNCTION

Relatively few data exist on atria( natriuretic peptide (ANP) characte ristics in Type 2 diabetes mellitus (DM). Therefore, plasma immunoreac tive ANP concentrations were measured before and for 4h following the ingestion of a physiological mixed meal in 8 newly diagnosed, normoten sive, normoalbuminuric, patients with Type 2 DM and 6 normotensive, no n-diabetic controls. In patients with Type 2 DM, basal plasma ANP conc entrations were 4.0 +/- 2.0 and not significantly changed following in gestion of the meal, with peak levels of 4.9 +/- 2.8 pmol l(-1). Non-d iabetic 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 (15 877 +/- 2679 vs 13 668 +/- 1792 ml(3)). Glomerular filtration rate (GFR) (iso topic clearance corrected for body surface area) was elevated in diabe tic patients (mean +/- SD) 130 +/- 39 vs 98 +/- 10 ml min(-1), p < 0.0 5). For the DM subjects, basal ANP revers were negatively correlated w ith GFR (r(s) -0.74, p < 0.05) and effective renal plasma flow (ERPF) (r(s) -0.8, p < 0.05). We conclude that patients with Type 2 DM demons trate reduced basal plasma ANP concentrations which are inversely corr elated to renal function. In contrast to non-diabetic controls, ANP in Type 2 DM does not rise in response to feeding. (C) 1998 John Wiley & Sons, Ltd.