Abstract
Background The diagnostic and prognostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in heart failure is well established. However, additional factors may influence its concentration. One of them is obesity, which in general is accompanied by reduced NT-proBNP levels. However, specific data concerning metabolic syndrome (MS) are equivocal. The aim of the present study was to evaluate the association of NT-proBNP with estimated insulin resistance (eIR) in men with MS. Methods In 86 male patients with MS (78 of them hypertensive), blood pressure, anthropometric measures, NT-proBNP, creatinine, glucose, and insulin were assessed and eIR was calculated using homeostatic model assessment (HOMA-IR). Results Both eIR and age were independently associated with NT-proBNP concentrations (b = 0.2248, p=0.019; b = 0.0102, p=0.049, respectively). Blood pressure, anthropometric measures, and eGFR were not correlated with NT-proBNP. Patients without eIR had higher NT-proBNP than those with eIR (32.2 ± 26.4 vs 21.4 ± 25.4 pg/mL, p=0.014). The difference was even higher in the younger subgroup of patients reaching nearly 50%. Conclusions Insulin resistance and, to a lesser degree, age were associated with NT-proBNP levels in men with MS. In younger subjects with eIR, mean NT-proBNP level was lower than in corresponding healthy age males.
Highlights
Amino-terminal pro-B-type natriuretic peptide (NTproBNP) is a neurohormone synthesized in the cardiac ventricles in response to increased wall tension and stretching
Study Group. e study included 86 male patients with metabolic syndrome (MS) diagnosed according to the IDF criteria [10] at the Military Institute of Medicine in Warsaw, Poland. e patients had no history of diabetes, chronic kidney disease, thyroid dysfunction, or cardiovascular disease
To NTproBNP, SBP and DBP were not correlated with WC, body mass index (BMI), and WHR (p > 0.4, detailed data not shown)
Summary
Amino-terminal pro-B-type natriuretic peptide (NTproBNP) is a neurohormone synthesized in the cardiac ventricles in response to increased wall tension and stretching. Its diagnostic and prognostic utility in heart failure is well established [1]. It does not have natriuretic activity as equimolar BNP but is more stable in circulation. Factors which may influence the concentration of natriuretic peptides in blood, except heart conditions, include age, body mass index (BMI), hemoglobin level, and kidney function [2]. Is correlation may to some extent compromise the diagnostic and prognostic value of NT-proBNP [4] unless a correcting factor is taken into consideration. Most of the data on associations between obesity and natriuretic peptides come from population studies, whereas studies focused solely on metabolic syndrome (MS) are scarce. Data on NT-proBNP concentration in MS, in which obesity is the main but not the only criterion, are equivocal ranging from reduced [2, 3, 5], through normal [6], to elevated [7]. e pathophysiology of the interdependence of obesity and natriuretic peptides in MS is not quite clear, and insulin resistance (IR) is implicated as a possible cause [8, 9]
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