Lege Artis Medicinae

[Acute volume load and atrial natriuretic peptide (ANP) secretion in endocrine disorders]

DE Chatel Rudolf1, TISLÉR András1, BARNA István1, TÓTH Miklós2, RUDOLF F. Lang3

JANUARY 29, 1992

Lege Artis Medicinae - 1992;2(01)

[The diuretic response to an acute volume load (2000 ml saline iv. in 4 hours), and systemic atrial natriuretic peptide (ANP) levels, measured by a radioimmunoassay were investigated in 57 patients with various endocrine disorders and the results compared to data obtained in 16 control subjects. In all groups post-infusion ANP levels were higher than pre-infusion levels. In hypothyroidism, and streak gonad syndrome basal ANP levels were lower (p<0.001) than in the control group. In both groups ANP increased significantly but remained significantly lower than the postinfusion value of the control group (p<0.001). Despite this, sodium and water excretion increased appropriately. In patients with disturbed Ca metabolism changes in ANP in response to saline infusion correlated with basal Ca levels (r=0.689, p<0.05). Basal ANP levels in diabetics did not differ from that of the control group. ANP increased more in the NIDDM group than in the other two (p<0.05), however, the natriuretic response was blunted in these patients. The results indicate that ANP is a hormonal mediator of the natriuretic and diuretic response to an acute saline load. In hypothyroidism low ANP levels are associated with normal natriuretic and diuretic responses. In patients with extreme serum Ca concentration the endocrine activity of the heart depends on Ca level. In NIDDM the endocrine responsiveness of the heart is increased, while peripheral sensitivity to the action of ANP is reduced. ]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem I. Sz. Belklinika
  2. Semmelweis Orvostudományi Egyetem Ér- és Szívsebészeti Klinika Budapest
  3. Philip Universität Institut für Normale und Phathologische Physiologie Marburg, BRD

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