Abstract
BackgroundThe effects of brain natriuretic peptide (BNP) on the risk of cardiovascular disease and atherosclerosis have been studied. However, little information is available regarding peripheral arterial disease (PAD), particularly among subjects with type-2 diabetes mellitus (T2DM). The aim of our study was to assess the potential relationship between BNP levels and PAD among T2DM patients.MethodsThe study cohort was 507 T2DM outpatients in which BNP levels were measured. Cross-sectional associations between BNP levels (in tertiles) and PAD were examined.ResultsCompared withT2DM patients without PAD, BNP levels were markedly higher in patients with PAD (p = 0.001). Correlation analyses showed that the BNP level was negatively correlated with the ankle–brachial index (r = −0.453, p = 0.033). At a cutoff value of 78.2 pg/ml, the BNP level showed a sensitivity of 71.9%, a specificity of 68.1%, and a positive predictive value of 84.3% for a diagnosis of PAD. The area under the receiver-operating characteristic curve increased significantly if BNP levels were incorporated into a predictive model of the potential risk factors for PAD (0.85 vs 0.81, p = 0.029).ConclusionsBNP is a potential and promising biomarker for PAD screening in T2DM patients.
Highlights
The effects of brain natriuretic peptide (BNP) on the risk of cardiovascular disease and atherosclerosis have been studied
Inclusion criteria were a diagnosis of type-2 diabetes mellitus (T2DM) according to criteria set by the American Diabetes Association [13] and peripheral arterial disease (PAD) was defined as arterial insufficiency with an ankle–brachial index(ABI) ≤0.90 in either leg [14]
The median BNP level was significantly higher in the PAD group than in the non-PAD group (78 [4.5–529] pg/ml vs. 71 [5.0–497] pg/ml, p = 0.001)
Summary
The effects of brain natriuretic peptide (BNP) on the risk of cardiovascular disease and atherosclerosis have been studied. Little information is available regarding peripheral arterial disease (PAD), among subjects with type-2 diabetes mellitus (T2DM). The aim of our study was to assess the potential relationship between BNP levels and PAD among T2DM patients. Peripheral arterial disease (PAD) is a subclinical measure of atherosclerotic vascular disease and a strong independent risk factor for cardiovascular disease (CVD) and mortality. Type-2 diabetes mellitus (T2DM) is associated with accelerated atherosclerosis and an increased risk of PAD. Brain natriuretic peptide (BNP) is secreted predominantly from the ventricular myocardium and is a useful predictor of cardiovascular disease risk [4]. Increasing evidences show that BNP is a useful marker
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