The Associations Between Metabolic Variables and NT-proBNP Are Blunted at Pathological Ranges: the Multi-Ethnic Study of Atherosclerosis

Overview

Journal Metabolism

Specialty Endocrinology

Date 2014 Jan 7

PMID 24388001

Citations 36

Authors

Otto A Sanchez

Daniel A Duprez

Hossein Bahrami

Lori B Daniels

Aaron R Folsom

Joao A Lima

Alan Maisel

Carmen A Peralta

David R Jacobs Jr

Affiliations

Soon will be listed here.

Abstract

Objective: Under physiological conditions brain natriuretic peptide (BNP) is inversely associated with metabolic risk factors, but under pathological conditions these associations may tend to plateau.

Material And Methods: 5597 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA), 45-84years of age, free of overt cardiovascular disease in 2000-02 and then again in 2003-05 participated in this study. Associations between NT-proBNP and BMI, blood lipids, homeostasis model of insulin resistance (HOMA-IR) using linear regression models were adjusted for age, race, sex, BMI, % of energy from saturated fats, intentional exercise, statin use, antihypertensive medication use, diabetes and glomerular filtration rate. The inflection points (IP) at which these associations became nonlinear were determined using linear splines with knots at different levels of NT-proBNP.

Results: Participants with NT-proBNP ≥100pg/mL (29%) tended to be older, on statins and anti-hypertensive medications vs. those with NT-proBNP <100pg/mL. The IP point varies among variables and ranged from 50-120pg/mL. NT-proBNP<IP, associated inversely with BMI, total cholesterol (TC), LDL-C, triglycerides (TG) and HOMA-IR, but positively with HDL-C. A higher proportion of participants with NT-proBNP ≥100pg/mL had subclinical CVD. All associations with NT-proBNP plateaued when NT-proBNP≥IP. Baseline level in NT-proBNP was not associated with 3-year change in BMI, TG, HDL-C or fasting glucose.

Conclusions: In a large cardiovascular disease-free cohort, NT-proBNP within the lower (physiological) range was inversely associated with TC, LDL-C, TG and insulin resistance with different inflection points, but at higher (pathological) levels these associations were blunted.

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