American Journal of Physiology-Renal Physiology, 2000
We assessed the effect of insulin and atrial natriuretic peptide (ANP) on renal sodium handling i... more We assessed the effect of insulin and atrial natriuretic peptide (ANP) on renal sodium handling in eight patients with sickle cell disease (SCD), who are characterized by loss of vasa recta and long loops of Henle, and matched control subjects. During insulin infusion (50 mU ⋅ kg−1⋅ h−1), fractional sodium excretion decreased by 0.44 ± 0.72% ( P = 0.13) in patients with SCD and by 0.57 ± 0.34% ( P = 0.002) in control subjects, whereas fractional distal sodium reabsorption increased by 4.1 ± 1.5% ( P < 0.001) and 3.0 ± 1.5% ( P < 0.001), respectively. Low-dose (0.3 pmol ⋅ kg−1⋅ h−1) ANP infusion did not affect renal sodium handling in patients with SCD but increased fractional sodium excretion by 0.34 ± 0.22% ( P= 0.003) in control subjects. High-dose (2 μg/min) ANP increased natriuresis to a similar extent in both groups. Insulin's antinatriuretic effects predominated over the natriuretic effects of low-dose, but not high-dose, ANP. These data suggest that insulin's an...
The Journal of Clinical Endocrinology & Metabolism, 2013
Background and Aims: High-density lipoproteins (HDLs) may directly stimulate β-cell function and ... more Background and Aims: High-density lipoproteins (HDLs) may directly stimulate β-cell function and glucose metabolism. We determined the relationships of fasting high-density lipoprotein cholesterol (HDL-C), plasma apolipoprotein (apo) A-I and apoA-II, and HDL-C–to–apoA-I and HDL-C–to–apoA-II ratios, as estimates of HDL particle composition, with incident type 2 diabetes mellitus. Methods: A prospective study was carried out in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort after exclusion of subjects with diabetes at baseline (n = 6820; age, 28–75 years). The association of HDL-related variables with incident type 2 diabetes was determined by multivariate logistic regression analyses. Results: After a median follow-up of 7.7 years, 394 incident cases of type 2 diabetes mellitus were ascertained (5.8%). After adjustment for age, sex, family history of diabetes, body mass index, hypertension, alcohol, and smoking, odd ratios (ORs) for diabetes were 0.55 (95% co...
Hyperinsulinemia supposedly contributes to hypertension in diabetes mellitus. We sought to determ... more Hyperinsulinemia supposedly contributes to hypertension in diabetes mellitus. We sought to determine if the renal and cardiovascular effects of insulin are preserved in diabetes despite resistance to its glucose-lowering effect. We studied the effects of two doses of insulin (50 and 500 milliunits/kg.hr-1), using the euglycemic clamp technique, on fractional sodium excretion, blood pressure, and heart rate in two groups of non-insulin-dependent diabetics: eight patients with and eight patients without hypertension. Hypertensive diabetics had higher basal insulin levels than normotensive diabetics (21.8 +/- 2.9 and 14.4 +/- 1.6 milliunits/l, respectively [mean +/- SEM]; p = 0.03). The degree of insulin resistance, but not plasma insulin levels, correlated with the height of mean arterial blood pressure (r = 0.60 and 0.73 at the low and high insulin dose, respectively; p less than 0.05). In contrast, the change in mean arterial blood pressure correlated negatively with the change in e...
American Journal of Physiology-Renal Physiology, 2000
We assessed the effect of insulin and atrial natriuretic peptide (ANP) on renal sodium handling i... more We assessed the effect of insulin and atrial natriuretic peptide (ANP) on renal sodium handling in eight patients with sickle cell disease (SCD), who are characterized by loss of vasa recta and long loops of Henle, and matched control subjects. During insulin infusion (50 mU ⋅ kg−1⋅ h−1), fractional sodium excretion decreased by 0.44 ± 0.72% ( P = 0.13) in patients with SCD and by 0.57 ± 0.34% ( P = 0.002) in control subjects, whereas fractional distal sodium reabsorption increased by 4.1 ± 1.5% ( P < 0.001) and 3.0 ± 1.5% ( P < 0.001), respectively. Low-dose (0.3 pmol ⋅ kg−1⋅ h−1) ANP infusion did not affect renal sodium handling in patients with SCD but increased fractional sodium excretion by 0.34 ± 0.22% ( P= 0.003) in control subjects. High-dose (2 μg/min) ANP increased natriuresis to a similar extent in both groups. Insulin's antinatriuretic effects predominated over the natriuretic effects of low-dose, but not high-dose, ANP. These data suggest that insulin's an...
The Journal of Clinical Endocrinology & Metabolism, 2013
Background and Aims: High-density lipoproteins (HDLs) may directly stimulate β-cell function and ... more Background and Aims: High-density lipoproteins (HDLs) may directly stimulate β-cell function and glucose metabolism. We determined the relationships of fasting high-density lipoprotein cholesterol (HDL-C), plasma apolipoprotein (apo) A-I and apoA-II, and HDL-C–to–apoA-I and HDL-C–to–apoA-II ratios, as estimates of HDL particle composition, with incident type 2 diabetes mellitus. Methods: A prospective study was carried out in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort after exclusion of subjects with diabetes at baseline (n = 6820; age, 28–75 years). The association of HDL-related variables with incident type 2 diabetes was determined by multivariate logistic regression analyses. Results: After a median follow-up of 7.7 years, 394 incident cases of type 2 diabetes mellitus were ascertained (5.8%). After adjustment for age, sex, family history of diabetes, body mass index, hypertension, alcohol, and smoking, odd ratios (ORs) for diabetes were 0.55 (95% co...
Hyperinsulinemia supposedly contributes to hypertension in diabetes mellitus. We sought to determ... more Hyperinsulinemia supposedly contributes to hypertension in diabetes mellitus. We sought to determine if the renal and cardiovascular effects of insulin are preserved in diabetes despite resistance to its glucose-lowering effect. We studied the effects of two doses of insulin (50 and 500 milliunits/kg.hr-1), using the euglycemic clamp technique, on fractional sodium excretion, blood pressure, and heart rate in two groups of non-insulin-dependent diabetics: eight patients with and eight patients without hypertension. Hypertensive diabetics had higher basal insulin levels than normotensive diabetics (21.8 +/- 2.9 and 14.4 +/- 1.6 milliunits/l, respectively [mean +/- SEM]; p = 0.03). The degree of insulin resistance, but not plasma insulin levels, correlated with the height of mean arterial blood pressure (r = 0.60 and 0.73 at the low and high insulin dose, respectively; p less than 0.05). In contrast, the change in mean arterial blood pressure correlated negatively with the change in e...
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