Computerized tomography measured liver fat is associated with low levels of N-terminal pro-brain natriuretic protein (NT-proBNP). Multi-Ethnic Study of Atherosclerosis

Abstract

Background and aims N-terminal pro B-type natriuretic peptide (NT-proBNP) is inversely associated with diabetes mellitus, obesity and metabolic syndrome. We aim to characterize the association between NT-proBNP and nonalcoholic fatty liver disease (NAFLD), a condition strongly associated with metabolic syndrome. Methods 4529 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) free of cardiovascular disease, without self-reported liver disease and not diabetic at their baseline visit in 2000- 2002 were included in this analysis. NAFLD was defined by a liver attenuation <40 HU. Relative prevalence (RP) for NAFLD was assessed adjusted for age, race, and sex, percent of dietary calories derived from fat, total intentional exercise, alcoholic drinks per week, and interleukin-6 by quintiles of NT-proBNP. Adjusted linear spline model was used to characterize a non-linear association between NT-proBNP and liver fat. The inflection point (IP) was the NT-proBNP concentration where there was a change in slope in the association between liver attenuation and NT-proBNP. Results RP for NAFLD decreased by 30% from the lowest to the highest quintile of NT-proBNP, p = 0.01. We observed an inverse linear association between NT-proBNP and liver fat, which plateaued (IP) at an NT-proBNP concentration of 45 pg/mL. Linear regression coefficient (SE) per unit of NT-proBNP < and ≥ IP was of 0.05 (0.02), p = 0.001 and 0.0006 (0.0008), p = 0.5, respectively, differences between slopes p < 0.0001. Conclusions In this cross-sectional study of a community based multiethnic sample of non-diabetic adults, low levels of NT-proBNP are associated with greater prevalence of NAFLD.

Natriuretic peptides in the control of lipid metabolism and insulin sensitivity

“…In obesity, the presence of non‐alcoholic fatty liver is frequently observed , which may further lead to non‐alcoholic steatohepatitis, liver cirrhosis or even liver carcinoma . Recent studies show inverse relationships between NPs, in particular N‐terminal proBNP, and liver fat content in individuals without diabetes or self‐reported liver disease , as well as between NPs and liver function as indicated by aminotransferase enzymes in individuals without cardiovascular disease . Additionally, NPs could ameliorate hepatic function as the presence of NP receptors was shown in the human liver .…”

Fatty Liver is Associated with Low N-terminal pro-B-type Natriuretic Peptide in a Healthy Population: From the Kangbuk Samsung Health Study

“…Both obesity and IR are associated with lower levels of NT-proBNP. Some studies have demonstrated that FL is associated with low NT-proBNP (6)(7)(8). Whether an IR or obesity-speci c factor decreases NT-proBNP levels in FL populations or whether common pathological mechanisms exist in FL and IR/obesity which decrease NT-proBNP levels is currently uncertain.…”

Endocrine regulation of lipid mobilization in human obesity

“…In the beginning of this millennium, natriuretic peptides (NPs), including atrial (ANP) and B-type (BNP) NPs, produced by the myocardium (by increasing NPs gene transcription and secretion of stored granules 169 ) in response to myotube distension 170 such as during exercise have been shown to be potent stimulators of human adipose tissue lipolysis 171 . By stimulating the guanylyl cyclase-linked type-A NP receptor (NPRA) on the adipocyte surface, NPs cause the conversion of intracellular GTP into cGMP.…”

“…isoproterenol) 177 . Unlike the cAMP-dependent pathway, NP-mediated lipolysis is unresponsive to the anti-lipolytic effects of insulin-mediated phosphodiesterase 3B (PDE3B) activation 171,176 . However, the NP pathway is counter-regulated via the hydrolysis of cGMP by other members of the PDE family, like PDE5 178,179 .…”

“…In obesity the presence of non-alcoholic fatty liver (NAFL) is frequently observed 169 , which may further lead to nonalcoholic steatohepatitis, liver cirrhosis or even liver carcinoma 170 . Recent studies show inverse relationships between NPs, in particular N-terminal-proBNP, and liver fat content in individuals without diabetes or self-reported liver disease 171 , as well as between NPs and liver function as indicated by aminotransferases enzymes in individuals without cardiovascular disease 172 .…”