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N-terminal pro-B-type natriuretic Peptide in overweight and obese patients with and without diabetes: an analysis based on body mass index and left ventricular geometry.

Abstract：

BACKGROUND AND OBJECTIVES:Several recent studies have shown that there is an inverse relationship between plasma B-type natriuretic peptide (BNP) and body mass index (BMI) in subjects with and without heart failure. Obesity frequently coexists with diabetes, so it is important to consider the relationship between diabetes and natriuretic peptide levels. We evaluated the influence of diabetes on the correlation of BNP and BMI. SUBJECTS AND METHODS:We examined 933 patients with chest pain and/or dyspnea undergoing cardiac catheterization between Feb. 2006 and Nov. 2007 in the Maryknoll cardiac center who had creatinine levels <2.0 mg/dL and normal systolic heart function. BMI was checked, transthoracic echocardiography was performed, and aminoterminal pro-brain natriuretic peptide (NT-proBNP) was sampled at the start of each case. RESULTS:In 733 non-diabetic patients, mean plasma NT-proBNP levels of non obese individuals (BMI <23 kg/m(2)), overweight individuals (23/=25 kg/m(2)) showed a significant negative correlation with increasing BMI (856.39+/-237.3 pg/mL, 601.69+/-159.6 pg/mL, 289.62+/-164.9 pg/mL, respectively, p<0.0001). However, in 200 diabetic patients, the correlation between BMI and NT-proBNP was not significant (r=-0.21, p=0.19), and NT-proBNP did not correlate with mitral E/Ea in obese diabetic patients (r=0.14, p=0.56). NT-proBNP was significantly correlated with mitral E/Ea in the non-obese (r=0.24, p=0.008) and non diabetic (r=0.32, p=0.003) groups. Left ventricular (LV) mass index was significantly correlated with NT-proBNP in all BMI groups (r=0.61, p<0.001), and patients with concentric cardiac hypertrophy showed the highest NT-proBNP levels. CONCLUSION:The present study demonstrates that obese patients have reduced concentrations of NT-proBNP compared to non obese patients despite having higher LV filling pressures. However, NT-proBNP is not suppressed in obese patients with diabetes. This suggests that factors other than cardiac status affect NT-proBNP concentrations.

journal_name

Korean Circ J

journal_title

Korean circulation journal

authors

Park SJ,Cho KI,Jung SJ,Choi SW,Choi JW,Lee DW,Lee HG,Kim TI

doi

10.4070/kcj.2009.39.12.538

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

538-44

issue

eissn

1738-5520

issn

1738-5555

journal_volume

pub_type

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N-terminal pro-B-type natriuretic Peptide in overweight and obese patients with and without diabetes: an analysis based on body mass index and left ventricular geometry.