Relationship between serum elevation of N-terminal pro-brain natriuretic peptide and malnutrition in very old male patients with normal ejection fraction

Abstract

Objective To investigate the association between malnutrition parameters and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in male patients aged ≥ 80 years with normal ejection fraction. Methods A total of 197 elderly male patients aged 80-95 years (average 85.4±9.7) were enrolled. Each patient received echocardiograms following admission, and ejection fraction was calculated. Serum concentrations of NT-proBNP were measured by electrochemiluminescence immunoassay. Multiple Logistic regression analyses and receiver operating characteristic (ROC) curves were used to assess the association between malnutrition parameters and serum level of NT-proBNP. Results Serum NT-proBNP level was higher in patients with malnutrition than in the controls 〔(711.9±1063.3) ng/L vs. (1375.2±1891.7) ng/L, P=0.006〕. Pearson correlation analysis showed that the malnutrition parameters such as body mass index (BMI), blood hemoglobin, albumin and pre-albumin were negatively correlated with serum NT-proBNP level (all P<0.05). Logistic regression analysis showed that BMI and serum pre-albumin level were independently associated with serum NT-proBNP level elevation (P=0.028 and 0.006, respectively). ROC curve analysis showed that the malnutrition parameters could predict the serum NT-proBNP level elevation. The area under the ROC curves for BMI, levels of blood hemoglobin, albumin and prealbumin in predicting serum NT-proBNP level elevation was 0.7 (P=0.002), 0.7 (P=0.004), 0.6 (P=0.036), 0.6 (P=0.002), the sensitivity was 75.5%, 51.0%, 38.8%, 89.8%, and the specificity was 54.4%, 70.2%, 84.2% and 31.6%, respectively. Conclusions The malnutrition parameters including BMI, blood hemoglobin, albumin and pre-albumin can predict serum NT-proBNP level elevation. BMI and serum pre-albumin level are independently associated with serum NT-proBNP level elevation in male patients aged ≥ 80 years with normal ejection fraction. Key words: Stroke Volume; Malnutrition; Natriuretic Peptid, brain