The relationship between glycemic control and BNP levels in diabetic patients

Dal, Kürşat; Ata, Naim; Yavuz, Bünyamin; Şen, Ömer; Deveci, Onur Sinan; Aksöz, Zekeriya; Yildirim, Aslihan Mete; Uygungelen, Bülent; Akın, Kadir Okhan; Beyan, Eśin; Ertuğrul, Derun Taner

doi:10.5603/cj.a2013.0109

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…Data demonstrated a positive correlation between BNP and HbA1c (r=0.345, p= 0.003). 15 This finding is consistent with ours as our data also showed a positive correlation between two variables in the diabetic group, which is independent of BMI. Thus, diabetic patients have higher NT-proBNP levels as compared to non-diabetics.…”

Section: Discussionsupporting

confidence: 93%

Clinical Utility of N-Terminal Prohormone B-Type Natriuretic Peptide Levels in Patients of Type 2 Diabetes Mellitus with Heart Failure

Janjua

Younas²,

Haroon³

et al. 2023

PAFMJ

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Objective: To evaluate the effect of type 2 diabetes mellitus on plasma N-terminal prohormone B-type natriuretic peptide levels in patients with heart failure and correlate it with glycosylated haemoglobin levels. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Chemical Pathology in collaboration with the Department of Cardiology,Combined Military Hospital, Multan Pakistan, from Feb to Sep 2021. Methodology: We assayed plasma NT-pro BNP levels in 194 individuals with established heart failure, (98 non-diabetics, and 96 patients with diabetes). Plasma NT-pro BNP levels were compared between groups in addition, the correlation of glycosylated haemoglobin with plasma NT-pro BNP levels was explored. Results: The mean plasma NT-pro BNP values were higher in patients with diabetes (15826.08 ±8143.434pg/mL) than in nondiabetics (12534.06±6323.92pg/mL) with a p-value 0.02. When NT-pro BNP was compared there was no significant found difference between the non-diabetic group and the Controlled Diabetes-Group (p-value 0 .882), but it was significantly higher in the Uncontrolled Diabetes-Group (p-value<0.001). A moderate positive association was found between NT-pro BNP and glycosylated haemoglobin (r=0.541, p-value<0.001). Conclusion: Although obesity has an inverse relation with plasma natriuretic peptides level and most patients with diabetes are overweight, the plasma NT-pro BNP is still a very informative tool and holds its significance as a diagnostic and prognosis marker in diabetic patients with heart failure.

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Section: Discussionsupporting

confidence: 93%

Clinical Utility of N-Terminal Prohormone B-Type Natriuretic Peptide Levels in Patients of Type 2 Diabetes Mellitus with Heart Failure

Janjua

Younas²,

Haroon³

et al. 2023

PAFMJ

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“…Moreover, the levels of hs-Tnl and BNP are closely correlated with each other after myocardial infarction, and high levels of troponin may reflect the severity of heart failure [43]. Second, this may be due to factors such as renal impairment and hyperglycemia that contribute to both elevated hs-Tnl and BNP in patients with T2DM [44, 45]. Nevertheless, recent studies demonstrated that perioperative glycemic control with exenatide infusion does not affect troponin and BNP release after cardiac surgery [46].…”

Section: Discussionmentioning

confidence: 99%

High-sensitivity troponin I and B-type natriuretic peptide biomarkers for prediction of cardiovascular events in patients with coronary artery disease with and without diabetes mellitus

Wong

Cheung

Tang

et al. 2019

Cardiovasc Diabetol

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BackgroundHigh-sensitivity troponin I (hs-Tnl) and B-type natriuretic peptide (BNP) are promising prognostic markers for coronary artery disease (CAD). This prospective cohort study investigated whether a combination of these cardiac biomarkers with conventional risk factors would add incremental value for the prediction of secondary major adverse cardiovascular events (MACEs) in patients with CAD, with and without type 2 diabetes mellitus (T2DM).MethodsBaseline plasma level of hs-Tnl and BNP was measured in 2275 Chinese patients with stable CAD. Patients were monitored for new-onset of MACE over a median of 51 months. Cox proportional hazard model and area under the receiver operating characteristic curve (AUC) were used to assess the association of cardiac biomarkers with MACE and their predictive values in relationship with or without T2DM.ResultsDuring the follow up period 402 (18%) patients experienced a new-onset MACE with hs-Tnl and BNP level significantly higher than in those without MACE. In multivariable analyses, patients with elevated hs-Tnl (hazard ratio, 1.75 [95% CI 1.41–2.17]; P < 0.001) and BNP (hazard ratio, 1.42 [95% CI 1.15–1.75]; P = 0.001) were significantly associated with an increased risk of MACE after adjustment for variables of a risk factor model of age, sex, T2DM and hypertension. The risk factor model had an AUC of 0.64 for MACE prediction. The AUC significantly increased to 0.68 by the addition of hs-Tnl to the risk factor model. Subgroup analyses showed that hs-Tnl and BNP remained significant predictors of MACE in both patients with and without T2DM in multivariable models with higher risk of MACE evident in those without T2DM. Among patients without T2DM, addition of each biomarker yielded greater predictive accuracy than in T2DM patients, with AUC further increased to 0.75 when a combination of hs-Tnl and BNP was added to the risk factor model (age, sex and hypertension).ConclusionsElevated hs-Tnl and BNP level are independent predictors of new-onset MACE in CAD patients, irrespective of diabetes status. Among CAD patients without T2DM, a combination of cardiac biomarkers hs-Tnl and BNP yield the greatest predictive value beyond conventional risk factors.

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“…The active form, BNP(1–32), is degraded by DPP4 by removing the two N-terminal amino acids (serine and proline) to produce BNP(3–32), which has reduced biological activity. Elevated levels of NPs were proved in hyperglycemia and decrease by improved glycemic control (Dal et al 2014 ). However, in cardiac pathology, it seems that DPP4 is implicated in high levels of NPs as it was found that genetic deletion of DPP4 improved the elevated levels of ANP and BNP in rats subjected to myocardial ischemia/reperfusion (Ku et al 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular protection by DPP-4 inhibitors in preclinical studies: an updated review of molecular mechanisms

Zakaria

Tawfeek

Hassanin

et al. 2022

Naunyn-Schmiedeberg's Arch Pharmacol

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Dipeptidyl peptidase 4 (DPP4) inhibitors are a class of antidiabetic medications that cause glucose-dependent increase in incretins in diabetic patients. One of the two incretins, glucagon-like peptide-1 (GLP-1), beside its insulinotropic activity, has been studied for extra pancreatic effects. Most of DPP4 inhibitors (DPP4i) have been investigated in in vivo and in vitro models of diabetic and nondiabetic cardiovascular diseases including heart failure, hypertension, myocardial ischemia or infarction, atherosclerosis, and stroke. Results of preclinical studies proved prominent therapeutic potential of DPP4i in cardiovascular diseases, regardless the presence of diabetes. This review aims to present an updated summary of the cardiovascular protective and therapeutic effects of DPP4 inhibitors through the past 5 years focusing on the molecular mechanisms beneath these effects. Additionally, based on the results summary presented here, future studies may be conducted to elucidate or illustrate some of these findings which can add clinical benefits towards management of diabetic cardiovascular complications.

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The relationship between glycemic control and BNP levels in diabetic patients

Abstract: (Cardiol J 2014; 21, 3: 252-256)

Cited by 15 publications

References 17 publications

Clinical Utility of N-Terminal Prohormone B-Type Natriuretic Peptide Levels in Patients of Type 2 Diabetes Mellitus with Heart Failure

Clinical Utility of N-Terminal Prohormone B-Type Natriuretic Peptide Levels in Patients of Type 2 Diabetes Mellitus with Heart Failure

High-sensitivity troponin I and B-type natriuretic peptide biomarkers for prediction of cardiovascular events in patients with coronary artery disease with and without diabetes mellitus

Cardiovascular protection by DPP-4 inhibitors in preclinical studies: an updated review of molecular mechanisms

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