Calcitonin Gene-Related Peptide: 24-Hour Profile and Responses to Volume Contraction and Expansion in Normal Men*

Abstract

Plasma immunoreactive calcitonin-gene related peptide (CGRP) concentrations were measured in 10 normal male subjects, aged 23-34 yr, who were studied under 3 separate conditions at intervals of at least 1 week. In phase 1, plasma CGRP concentrations were measured hourly for 24 h during normal activity; in phase 2, the CGRP response to diuretic-induced volume depletion and upright posture was measured over 3 h; in phase 3, the CGRP response to volume loading and supine posture was measured over 4 h. During phase 1, the mean 24-h plasma CGRP concentration averaged 30 +/- 16 pmol/L; hourly CGRP concentrations ranged from 25-37 pmol/L over 24 h and oscillated from 16% below to 27% above the mean 24-h CGRP value, changes that were highly significant (P = 0.005). The peaks were at 0600 and 0700 h, while the nadirs were at 1200 and 2000 h. No significant difference was found between fasting CGRP at 0800 h and levels taken 1, 2, and 3 h postprandially (P = 0.68). During phase 2 (volume depletion and upright) mean plasma CGRP rose significantly, going from a baseline of 42 +/- 8 pmol/L at 0800 h to a peak of 60 +/- 10 pmol/L at 1100 h (P = 0.0005). The percent CGRP increment was relatively small (26% to 42%) compared to the rise in PRA (518% to 1033%) and aldosterone concentrations (333% to 465%). Hematocrit increased from 40.5 +/- 0.7% to 45.8 +/- 0.7% (P = 0.0001) in phase 2, while serum osmolality did not change significantly. In phase 3 (volume loading and supine), plasma CGRP did not change significantly, while PRA and aldosterone concentrations fell significantly (P = 0.0001); neither serum osmolality nor hematocrit changed significantly. We conclude that plasma CGRP concentrations fluctuate spontaneously and significantly during the day, and rise in response to volume depletion. The reasons for the CGRP fluctuations seen over 24 h, which are not apparent from this study, may be related to changes in vascular volume or other as yet unidentified factors. These studies are consistent with the concept that CGRP, acting either directly or through the renin-aldosterone system, may have a role in regulating peripheral vascular tone or controlling vascular volume.