Relation of Visceral Adiposity to Circulating Natriuretic Peptides in Ambulatory Individuals

Cheng, Susan; Fox, Caroline S.; Larson, Martin G.; Massaro, Joseph M.; McCabe, Elizabeth L.; Khan, Abigail; Levy, Daniel; Hoffmann, Udo; O’Donnell, Christopher J.; Miller, Karen K.; Newton‐Cheh, Christopher; Coviello, Andrea D.; Bhasin, Shalender; Vasan, Ramachandran S.; Wang, Thomas J.

doi:10.1016/j.amjcard.2011.05.033

Cited by 50 publications

(55 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7 Another biological plausible mechanism linking VAT to human hypertension involves decreased activity of the NP system. It is well known that obese individuals have lower circulating NP concentrations, but studies from both the Dallas Heart Study 10 and the Framingham Heart Study 39 showed that increased VAT, determined by MRI or CT, in contrast to SAT, was significantly negatively associated with circulating concentrations of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide after multivariate adjustment. On the basis of these findings, it is reasonable to suggest that the lower amount of circulating B-type natriuretic peptide associated with increased VAT, resulting in diminished vasodilation and natriuresis, 40 could be involved in the pathogenesis of increased VAT-related hypertension in early stages of this disease.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population

et al. 2016

View full text Add to dashboard Cite

Abstract-Abdominal obesity is a major risk factor for hypertension. However, different distributions of abdominal adipose tissue may affect hypertension risk differently. The main purpose of this study was to explore the association of subcutaneous abdominal adipose tissue (SAT) and visceral adipose tissue (VAT) with incident hypertension in a population-based setting. We hypothesized that VAT, rather than SAT, would be associated with incident hypertension. VAT and SAT were determined by ultrasound imagining in 3363 randomly selected Danes (mean age 49 years, 56% women, mean body mass index 25.8 kg/m 2 ). We constructed multiple logistic regression models to compute standardized odds ratios with 95% confidence intervals per SD increase in SAT and VAT. Of the 2119 normotensive participants at baseline, 1432, with mean SAT of 2.8 cm and mean VAT of 5.7 cm, returned 5 years later for a follow-up examination and among them 203 had developed hypertension. In models including both VAT and SAT, the Framingham Hypertension Risk Score variables (age, sex, smoking status, family history of hypertension, and baseline blood pressure) and glycated hemoglobin, odds ratio (95% confidence interval) for incident hypertension for 1 SD increase in VAT and SAT was 1.27 (1.08-1.50, P=0.004) and 0.97 (0.81-1.15, P=0.70), respectively. Adjusting for body mass index instead of SAT attenuated the association between VAT and incident hypertension, but it was still significant (odds ratio, 1.22 [1.01-1.48, P=0.041] for each SD increase in VAT). In conclusion, ultrasound-determined VAT, but not SAT, was associated with incident hypertension in a random sample of Danish adults.

show abstract

Section: Discussionmentioning

confidence: 99%

Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Reduced natriuretic peptide levels have previously been observed in a number of conditions including obesity, diabetes mellitus, and insulin resistance (28-33). These conditions are more common among black individuals and while some studies suggest that blacks may have lower natriuretic peptide levels than whites (16-20), these prior reports did not specifically focus on race/ethnic differences in natriuretic peptide levels while accounting for comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Natriuretic Peptide Levels

Gupta

Lemos

Ayers

et al. 2015

JACC: Heart Failure

Self Cite

View full text Add to dashboard Cite

Background Natriuretic peptides (NP) are hormones with natriuretic, diuretic, and vasodilatory effects. Experimental NP deficiency promotes salt-sensitive hypertension and cardiac hypertrophy, conditions that are more common among black individuals. We hypothesized that black individuals have lower N-terminal pro B-type natriuretic peptide (Nt-proBNP) levels than white and Hispanic individuals. Objectives To assess whether Nt-proBNP levels differ according to race/ethnicity. Methods We examined plasma Nt-proBNP levels according to race/ethnicity in 3,148 individuals (51% black, 31% white, 18% Hispanic) free of prevalent cardiovascular disease in the Dallas Heart Study. Nt-proBNP values in the bottom sex-specific quartile were defined as low. Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates and MRI measurements of cardiac structure and function. Results Hypertension was present in 41%, 25%, and 16% of black, white, and Hispanic individuals, respectively. Unadjusted Nt-proBNP levels were lowest in blacks (median 24 pg/ml; IQR 10, 52) as compared with Hispanic (30 pg/ml; IQR 14, 59) and white individuals (32 pg/ml; IQR 16, 62), P < 0.0001. In multivariable-adjusted models, black individuals still had significantly lower Nt-proBNP levels (-39% [95%CI -46%, -31%]; P < 0.0001) and greater odds of having low Nt-proBNP (OR: 2.46, [95% CI 1.86, 3.26]), compared with whites. In contrast, Nt-proBNP levels did not significantly differ between Hispanic and white individuals (P = 0.28). The finding of lower Nt-proBNP levels in blacks was similar when analyses were restricted to healthy participants without cardiovascular risk factors. Conclusions In this multi-ethnic cohort, Nt-proBNP levels differ substantially according to race/ethnicity. Despite a higher prevalence of hypertension, blacks had significantly lower NP levels than white and Hispanic individuals. A relative NP “deficiency” among black individuals may lead to greater susceptibility to salt retention and hypertension.

show abstract

“…For example, in the Framingham Heart Study, the inverse relationship between NT-pro-BNP and abdominal adipose tissue mass was stronger for visceral, compared to subcutaneous, adiposity (33). Furthermore, lower BNP concentrations have been associated with the metabolic syndrome and its components, even after statistical adjustment for obesity (9,34,35).…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance is Associated with Increased Concentrations of NT-proBNP in Rheumatoid Arthritis: IL-6 as a Potential Mediator

et al. 2014

View full text Add to dashboard Cite

Objectives To examine the hypothesis that insulin resistance (IR) decreases circulating concentrations of NT-pro brain natriuretic peptide (BNP). Background Obesity, despite being a risk factor for heart failure (HF), is paradoxically associated with lower concentrations of BNP, a marker of myocardial stress. Low BNP in obesity is postulated to be due to IR; however, it has been difficult to define the role of IR independent of obesity. IR in rheumatoid arthritis (RA) is increased, independent of obesity, thus allowing potential mechanistic insights into the relationship between IR and BNP. Methods We measured demographic factors, traditional cardiovascular risk factors, body mass index (BMI), markers of inflammation (interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor α (TNFα)), NT-pro-BNP, and IR by the homeostatic model assessment (HOMA) in 140 patients with RA and 82 control subjects. Patients with heart failure and coronary artery disease were excluded. We used multiple linear regression models to examine the relationship between HOMA and NT-pro-BNP in RA and controls, and in RA alone, the additional effect of inflammation. Results As previously reported, NT-pro-BNP concentrations were higher in RA (median 80.49 pg/mL, IQR (23.67–167.08 pg/mL) than controls (17.84 pg/mL (3.28–36.28 pg/mL)) (P<0.001), and the prevalence of IR, defined by HOMA>2.114, was higher among RA than controls (53% vs. 15%, P>0.001). HOMA was positively correlated with NT-pro-BNP (rho=0.226, P=0.007) in RA, but not in controls (rho=−0.154, P=0.168). In a multivariable model adjusted for age, race and sex, we found that increasing HOMA was statistically associated with increasing NT-pro-BNP concentrations in RA (P=0.001), but not controls (P=0.543) (P for interaction = 0.036). In RA subjects, when IL-6 was further included in the model, IL-6 (P=0.0014), but not HOMA (P=0.43), remained significantly associated with NT-pro-BNP, suggesting that IL-6 may be mechanistically involved in the relationship between IR and NT-pro-BNP in RA. Conclusions We conclude that in patients with RA, insulin resistance is associated with higher, rather than the expected lower, concentrations of NT-pro-BNP and that this may be related to increased IL-6.

show abstract

Relation of Visceral Adiposity to Circulating Natriuretic Peptides in Ambulatory Individuals

Cited by 50 publications

References 29 publications

Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population

Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population

Racial Differences in Natriuretic Peptide Levels

Insulin Resistance is Associated with Increased Concentrations of NT-proBNP in Rheumatoid Arthritis: IL-6 as a Potential Mediator

Contact Info

Product

Resources

About