Short term variation in NTproBNP after lifestyle intervention in severe obesity

Abstract

AimNatriuretic peptides are not only involved in cardiovascular adaption to various conditions, but also in metabolic diseases. We performed this study to assess the effect of a very short time of lifestyle inpatient intervention on NTproBNP values in normotensive subjects with severe obesity and normal cardiac function.MethodsWe recruited 14 consecutive obese normotensive subjects with normal cardiac function who were aged 30 years and more and were referred to inpatient rehabilitation in an academic clinic over a two months period. They were examined at baseline and after a 3-weeks program including dietary intervention with hypocaloric diet and assisted personalized physical aerobic and anaerobic activities and compared to age, sex and BMI-matched control subjects under usual care.ResultsBMI significantly decreased (40.8 ±1.6 vs 42.3 ± 1.6 kg/m2, p <0.0001). Median reduction in body weight was 4.9 kg (interquartile range 2.4–5.2 kg). After diet and exercise-induced weight loss, plasma NTproBNP levels showed an almost two-fold increase, which was statistically significant (28.2 ± 12.3 vs 17.2 ± 13.2 ng/L, p = 0.01), and particularly relevant in the subgroup with NT-proBNP values below median values compared to those with higher values (p = 0.02). No significant variations were found in control subjects (18.0 ± 13.0 vs 16.5 ± 11.2 ng/L, p = 0.18). The lipid profile was significantly ameliorated, and both HbA1c and insulin levels showed a marginally non-significant decrease after treatment.ConclusionsAn almost two-fold increase in NTproBNP levels was evident after a very short time period of lifestyle intervention in normotensive severe obese patients without cardiac disease. This finding might have clinical relevance, considering the role of NT-proBNP as risk factor of impaired glucose tolerance.

Renal and Cardiovascular Effects of SGLT2 Inhibition in Combination With Loop Diuretics in Patients With Type 2 Diabetes and Chronic Heart Failure

“…This may in part be attributable to weight loss, which has been reported as causing an increase in NT-proBNP. 28 , 29 …”

Reduced risk of heart failure with intensified multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: 21 years of follow-up in the randomised Steno-2 study

“…Our findings indicate that the higher risk of heart failure associated with an increase in NT-proBNP can be mitigated by intensified multifactorial intervention. However, evidence that intensive lifestyle improvement may increase NT-proBNP and the fact that NT-proBNP levels are inversely related to BMI warrants caution when interpreting our findings regarding NT-proBNP [ 25 , 26 ].…”

Natriuretic Peptides in Cardiovascular and Metabolic Crosstalk

“…22 In other studies, multimodal interventions, including exercise and hypocaloric dieting substantially increased NT-proBNP and MR-proANP concentrations. [34][35][36]…”