Inverse Association of N-Terminal Pro-B-Type Natriuretic Peptide with Metabolic Syndrome in Patients with Congestive Heart Failure

Abstract

BackgroundMetabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF).MethodsFasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.ResultsForty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = −0.297), plasma triglyceride (β = −0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = −0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients.ConclusionsPlasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.

Association Between Cardiac Natriuretic Peptides and Lipid Profile: a Systematic Review and Meta-Analysis

“…Twenty-seven studies 20,21,24–26,31–34,38,39,41,43,48,49,51,54–58,60–64,66 reported the association between cardiac NPs and TC, for a total of 43428 subjects evaluated. Twenty-eight studies 20–25,27–30,32–34,37–39,44,45,51,52,55–57,59,61,63,64,66 reported the association between cardiac NPs and LDLc, for a total of 44829 subjects evaluated.…”

“…Twenty-eight studies 20–25,27–30,32–34,37–39,44,45,51,52,55–57,59,61,63,64,66 reported the association between cardiac NPs and LDLc, for a total of 44829 subjects evaluated. Thirty-six studies 20,21,24–26,31–34,38,39,41,43,48,49,51,54–58,60–64,66 reported the association between cardiac NPs and HDLc, for a total of 49951 subjects evaluated. Thirty-nine studies 20–30,32–42,44–47,50–57,59–64 reported the association between cardiac NPs and TG, for a total of 39649 subjects evaluated.…”

“…They found that patients with dyslipidemia had lower NT-proBNP levels that were inversely associated with higher levels of both TC and TG. Afterwards, many other studies investigated the relationship between cardiac NPs and lipid profile, particularly in the context of the MetS 20,22,24,25,30,45,47,60,62,64 . Indeed, a close association between NPs system and MetS is well recognized 72 .…”

B-type natriuretic peptide and cirrhosis progression

“…High BNP levels correlate with left ventricular dysfunction and its prognosis (Chang et al, 2013;Geske et al, 2013). However, high levels of BNP also have been found in congestive states such as heart and renal failure and in chronic liver disease (Passino et al, 2008).…”

Brain Natriuretic Peptide in Cirrhosis

“…Higher BNP levels are linked with poor outcome, worst prognosis and higher mortality rate [13]. The measured value correlates with severity of disease and its prognosis [14,15].…”