Abstract
AimsLong-acting natriuretic peptide (LANP) is one of the peptide hormones in atrial natriuretic peptide (ANP) pro-hormone. Low levels of natriuretic peptide may lead to reduced lipolysis and excessive weight gain in obese patients. The aim of this study was to investigate the relationship between fasting serum LANP level and the metabolic syndrome (MetS) among congestive heart failure (CHF) patients.MethodsFasting blood samples were obtained from 186 patients with normal renal function in cardiac clinic outpatients. CHF defined by the American College of Cardiology Foundation and the American Heart Association 2005 Guidelines. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation.ResultsNinety-eight patients (52.7%) had CHF. There was a tendency of increased fasting LANP levels as the NYHA CHF functional classes increased (p = 0.002). Forty-six of the CHF patients (46.9%) had MetS. Fasting LANP level negatively correlated with MetS among CHF patients (p < 0.001). Univariate linear regression analysis showed that BUN (p = 0.026) positively correlated with fasting serum LANP levels, while body weight (p = 0.009), BMI (p = 0.004), homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.024) and HOMA-β (p = 0.001) negatively correlated with fasting serum LANP levels among the CHF patients. Multivariate forward stepwise linear regression analysis of the significant variables showed that the HOMA-β (R2 change = 0.292, p < 0.001) and HOMA-IR (R2 change = 0.081, p = 0.019) were independent predictors of fasting serum LANP levels in CHF patients.ConclusionsLANP level is significantly reduced in CHF patients affected by MetS. HOMA-β and HOMA-IR were independent predictors of serum LANP levels in CHF patients.
Highlights
There are four peptide hormones derived from the 126amino acid atrial natriuretic peptides (ANP) pro-hormone: long-acting natriuretic peptide (LANP; N-terminal proANP 1–30), vessel dilator (N-terminal pro-ANP 31–67), kaliuretic peptide (N-terminal pro-ANP 79–98), and ANP (α-ANP) and these peptide hormones have significant diuretic, natriuretic, and blood-pressure-lowering properties in animals and humans [1]
The results of our study showed that the fasting LANP level was negatively associated with metabolic syndrome (MetS) in congestive heart failure (CHF) patients
Our study found that blood urea nitrogen (BUN) positively correlated with fasting serum LANP levels among the CHF patients
Summary
There are four peptide hormones derived from the 126amino acid atrial natriuretic peptides (ANP) pro-hormone: long-acting natriuretic peptide (LANP; N-terminal proANP 1–30), vessel dilator (N-terminal pro-ANP 31–67), kaliuretic peptide (N-terminal pro-ANP 79–98), and ANP (α-ANP) and these peptide hormones have significant diuretic, natriuretic, and blood-pressure-lowering properties in animals and humans [1]. A recent study noted that MetS predicted CHF independent of interim myocardial infarction and prevalent diabetes in elderly Finns during a 20-year follow-up [6]. CHF was associated with insulin resistance independent of diabetes mellitus in a large community-based sample of elderly men [7]. It can be speculated that low levels of natriuretic peptide may lead to reduced lipolysis and excessive weight gain in obese patients, which may be one of the biological alterations that contribute to the development of obesity [8]. Lower plasma N-terminal pro-ANP levels were associated with the development of insulin resistance (HOMA-IR) and MetS [9]. There is no study about the association between serum LANP levels and MetS in CHF patients. The aim of this study was to investigate the relationship between fasting serum LANP level and the MetS among CHF patients
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