Effects of insulin on plasma renin activity, plasma atrial natriuretic peptide and gody fluid volume in diabetes mellitus.
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概要
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The effects of insulin treatment on plasma renin activity (PRA), plasma atrial natriuretic peptide (ANP) and body fluid volume were studied in 16 hospitalized patients with insulin-independent diabetes mellitus. Parameters were recorded for 2 days during treatment by diet alone and for 3 weeks after starting insulin. Blood samples were obtained weekly from 9 patients for the measurement of fasting plasma glucose, hematocrit, PRA and plasma ANP. A 24-hr urine sample was collected to determine the urinary excretion of glucose and sodium. In a separate group of 7 patients, plasma volume and extracellular fluid volume were determined by the Evans blue and sodium thiocyanate dilution tests, respectively.In the group of 9 diabetic patients, significant (p<0.05) reductions in fasting plasma glucose, hematocrit and the urinary excretion of sodium and glucose were seen with insulin treatment. PRA fell significantly (p<0.05) from 5.2±1.2ng/ml/hr (mean±SEM) on the control days to 2.3±0.5 on the 21st day after starting treatment. Plasma levels of ANP averaged 35±5pg/ml on the control days and these did not change significantly. In the other group of 7 patients, both plasma volume and extracellular fluid volume increased significantly (p<0.05) with insulin treatment. A sodium-retaining effect of insulin and a decrease in osmotic diuresis may have increased the body fluid volume and caused the fall in PRA. Thus, a vasodilatory action of insulin may assist in compensation for the increase in body fluid volume, preventing a rise in plasma ANP levels.
- International Heart Journal刊行会の論文
著者
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KURASHINA Toshiaki
Second Department of Internal Medicine, Gunma University School of Medicine
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Ichikawa Shuichi
Cardiovascular Hospital of Central Japan
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Sato Kunio
Second Department Of Internal Medicine Gunma University School Of Medicine
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Sakamaki Tetsuo
Second Department of Internal Medicine, Gunma University School of Medicine
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MURATA Kazuhiko
Second Department of Internal Medicine, Gunma University School of Medicine
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Sakamaki Tetsuo
Second Department Of Internal Medicine Gunma University School Of Medicine
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Nakamura Tetsuya
Second Department Of Internal Medicine Gunma University School Of Medicine
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MURATA Kazuhiko
Second Department of Internal Medicine and the First Department of Pathology, Gunma University School of Medicine
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AIZAWA Futao
Second Department of Internal Medicine, Gunma University School of Medicine
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FUJIE Masao
Second Department of Internal Medicine, Gunma University School of Medicine
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