September 1, 1993AJP Regulatory Integrative and Comparative Physiology
Atrial natriuretic factor counteracts sodium-retaining actions of insulin in normal men
Key result
Acute insulin reduces sodium excretion ~34%, an effect abolished by simultaneous ANF infusion.
- P<0.001
- n=16
Why the study?
Hyperinsulinemia is hypothesized to cause hypertension by increasing renal sodium retention, but the interaction with atrial natriuretic factor on sodium handling is unclear.
Does atrial natriuretic factor counteract the sodium-retaining actions of insulin in healthy men?
Population
16 healthy men
Comparison
Acute administration of insulin, low-dose ANF, or both simultaneously
Design
Physiological study with standard clearance techniques
Follow-up
Three occasions approximately 1 week apart
Authors
Discussion
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Implication
Insulin reduces sodium excretion via an ANF-sensitive pathway in healthy volunteers; leaves open its relevance to sodium balance in insulin-resistant states.
Structured PICO
Does atrial natriuretic factor counteract the sodium-retaining actions of insulin in healthy men?
P
Population
16 healthy men studied on three occasions to evaluate renal sodium transport responses to acute administration of insulin and ANF.
I
Intervention
Acute administration of insulin (euglycemic clamp to increase plasma insulin 10-fold), low-dose atrial natriuretic factor (ANF, 0.3 pmol.kg-1.min-1), or both simultaneously
C
Comparator
Baseline values and individual interventions compared against each other
O
Outcome
Sodium excretionsurrogate
Main Result
Absolute Event Rate: 0.207% vs 0.315%
p-value: p=<0.001
Physiological increases in plasma ANF abolish the sodium-retaining action of insulin, suggesting that hyperinsulinemia-induced hypertension may rely on mechanisms other than renal sodium retention.
Cite This Study
Miller et al. (1993) studied Healthy (n=16). Insulin and low-dose ANF vs. Baseline was evaluated on Sodium excretion (p=<0.001). Acute administration of insulin in healthy men reduced sodium excretion from 0.315 to 0.207 mmol/min (P<0.001), an effect that was abolished by simultaneous low-dose ANF infusion.