Effect of Experimental Obesity and Subsequent Weight Reduction upon Circulating Atrial Natriuretic Peptide

Crandall, David L.; Ferraro, Gregory D.; Cervoni, Peter

doi:10.3181/00379727-191-42932

Cited by 19 publications

(15 citation statements)

References 10 publications

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“…Therefore, for the first time, we demonstrated that, in humans, calorie intake and body weight are important modulators of the humoral, renal, and hemodynamic effects not only of exogenous ANP but also of the endogenous NP system. Our findings are in agreement with those of Crandall et al, 25 showing that, in experimental obesity, diuresis and natriuresis accompanying weight reduction may be due to increased activity of ANP.…”

Section: Discussionsupporting

confidence: 83%

“…24 Finally, in experimental obesity, weight reduction might facilitate ANP activity, inducing diuresis and natriuresis. 25 These findings are consistent with the hypothesis that the abundance of clearance receptors in the total adipose mass of obese hypertensives might play some role in obesity-related hypertension by reducing the biological activity of circulating ANP.…”

supporting

confidence: 81%

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Low Calorie Diet Enhances Renal, Hemodynamic, and Humoral Effects of Exogenous Atrial Natriuretic Peptide in Obese Hypertensives

et al. 1999

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The expression of the natriuretic peptide clearance receptor is abundant in human and rat adipose tissue, where it is specifically inhibited by fasting. In obese hypertensives, plasma atrial natriuretic peptide (ANP) levels were found to be lower than in obese normotensives. Therefore, the increased adipose mass might influence ANP levels and/or its biological activity. The aim of the present study was to evaluate whether the humoral, hemodynamic, and renal effects of exogenous ANP in obese hypertensives might be enhanced by a very low calorie diet. Eight obese hypertensives received a bolus injection of ANP (0.6 mg/kg) after 2 weeks of a normal calorie/normal sodium diet, and blood pressure (BP), heart rate, ANP, cGMP, plasma renin activity, and aldosterone were evaluated for 2 hours before and after the injection. Diuresis and natriuresis were measured every 30 minutes. The patients then started a low calorie/normal sodium diet (510 kcal/150 mmol/d) for 4 days, and then the ANP injection protocol was repeated. The low calorie diet induced a slight weight loss (from 90.61.1 to 87.71.2 kg; P0.01), which was accompanied by increase of cGMP excretion (from 146.010.1 to 154.59.5 nmol/24 h; P0.05) together with a reduction of BP (P0.01 versus basal levels). ANP injection after diet was followed by an increase of ANP levels similar to that observed before diet, but plasma cGMP, diuresis, and natriuresis increased significantly only after diet. Similarly, the decrease of BP after ANP administration was significantly higher after diet (change in mean arterial pressure, 6.40.7 versus 4.00.6 mm Hg; P0.05) as well as that of aldosterone (P0.01). These data show that a low calorie diet enhances the humoral, renal, and hemodynamic effects of ANP in obese hypertensives and confirm the importance of caloric intake in modulating the biological activity of ANP, suggesting that the natriuretic peptide system can play a role in the acute changes of natriuresis and diuresis associated with caloric restriction. (Hypertension. 1999;33:658-662.) Key Words: obesity hypertension natriuretic peptides, atrial cyclic GMP diuresis natriuresis S everal epidemiological and clinical studies have shown that excess weight and weight gain contribute to increase blood pressure (BP) in a large proportion of hypertensive patients. 1-3 Such studies have also demonstrated that BP in the adult is highly correlated to body mass index (BMI). 4,5 Although the association between obesity and hypertension is widely recognized, the pathophysiology of weight-related change in BP is a matter of debate. Several mechanisms have been suggested to play a role in the pathogenesis of obesity-related hypertension, such as increased plasma volume and cardiac output, 6 enhanced sympathetic nervous system activity , 7 hyperinsulinemia and insulin resistance, 8 and nutritional factors such as high sodium intake and/or sodium retention. 9 Moreover, the importance of weight gain per se in causing hypertension is reinforced by experimental studies showing that weight gain ...

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Section: Discussionsupporting

confidence: 83%

supporting

confidence: 81%

Low Calorie Diet Enhances Renal, Hemodynamic, and Humoral Effects of Exogenous Atrial Natriuretic Peptide in Obese Hypertensives

et al. 1999

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“…In an experimental study with obese rats and subsequent weight reduction through caloric restriction, Crandall et al [12] found that circulating atrial NP levels were significantly elevated after a 40% reduction in body weight. Furthermore, an analysis of heart-to-body weight ratios showed that an obesity-associated, volume-induced cardiac hypertrophy remained even after normalization of body fat.…”

Section: Discussionmentioning

confidence: 97%

“…Indeed, cardiac cachexia is known to be an independent predictor of decreased survival [11]. Furthermore, there is evidence that circulating lipoproteins in obese patients may bind and detoxify the lipopolysaccharides that play a role in stimulating inflammatory cytokines [12].…”

mentioning

confidence: 99%

B-type natriuretic peptide increases after gastric bypass surgery and correlates with weight loss

et al. 2011

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“…24,25 In experimental animals, caloric deprivation through fasting results in dramatic decreases in NPR-C gene expression 26 and increased circulating ANP levels. 27 Elevated NPR-C gene expression has been documented in the adipose tissue of humans with obesity and hypertension, 5 and allelic variants of this gene have been associated with lower plasma natriuretic peptide levels. 28 Reduced secretion of natriuretic peptides from diminished myocardial hormone release 6 or impaired synthesis 29 may also be an important explanation for low plasma natriuretic peptide levels.…”

Section: Mechanisms For Reduced Natriuretic Peptide Levels In Obesitymentioning

confidence: 99%

Impact of Obesity on Plasma Natriuretic Peptide Levels

et al. 2004

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Background-The mechanisms linking obesity to hypertension have not been established, but sodium retention and excessive sympathetic tone are key contributors. The natriuretic peptides are important regulators of sodium homeostasis and neurohormonal activation, raising the possibility that obese individuals have an impaired natriuretic peptide response. Methods and Results-We examined the relations of plasma B-type natriuretic peptide (BNP) and N-terminal proatrial natriuretic peptide (N-ANP) to body mass index in 3389 Framingham Study participants (1803 women) without heart failure. Multivariable regression analyses were performed, adjusting for clinical and echocardiographic covariates. BNP levels below the assay detection limit and N-ANP levels in the lowest sex-specific quartile were categorized as low. Multivariable-adjusted mean plasma BNP levels in lean (Ͻ25 kg/m 2 ), overweight (25 to 29.9 kg/m 2 ), and obese (Ն30 kg/m 2 ) men were 21.4, 15.5, and 12.7 pg/mL, respectively (trend PϽ0.0001). Corresponding values in women were 21.1, 16.3, and 13.1 pg/mL (trend PϽ0.001). A similar pattern was noted for plasma N-ANP. Obese individuals had higher odds of having low plasma BNP (multivariable-adjusted odds ratios: men, 2.51; 95% CI, 1.71 to 3.68; women, 1.84; 95% CI, 1.32 to 2.58) and low plasma N-ANP (odds ratios: men, 4.81; 95% CI, 2.98 to 7.76; women, 2.85; 95% CI, 2.01 to 4.04) compared with lean individuals. Diabetes also was associated with low plasma natriuretic peptide levels, and the negative effects of obesity and diabetes on natriuretic peptide levels were additive. Conclusions-Obese individuals have low circulating natriuretic peptide levels, which may contribute to their susceptibility to hypertension and hypertension-related disorders.

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Effect of Experimental Obesity and Subsequent Weight Reduction upon Circulating Atrial Natriuretic Peptide

Cited by 19 publications

References 10 publications

Low Calorie Diet Enhances Renal, Hemodynamic, and Humoral Effects of Exogenous Atrial Natriuretic Peptide in Obese Hypertensives

Low Calorie Diet Enhances Renal, Hemodynamic, and Humoral Effects of Exogenous Atrial Natriuretic Peptide in Obese Hypertensives

B-type natriuretic peptide increases after gastric bypass surgery and correlates with weight loss

Impact of Obesity on Plasma Natriuretic Peptide Levels

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