Visceral fat is negatively associated with B-type natriuretic peptide levels in patients with advanced type 2 diabetes

Sugisawa, Takako; Kishimoto, Ichiro; Kokubo, Yoshihiro; Nagumo, Ayako; Makino, Hisashi; Miyamoto, Yoshihiro; Yoshimasa, Yasunao

doi:10.1016/j.diabres.2010.03.012

Cited by 18 publications

(24 citation statements)

References 21 publications

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“…A study of 608 patients with type 2 diabetes from Japan demonstrated an inverse association between BNP and BMI, with a more robust inverse association between BNP and visceral fat compared with other measures of adiposity (25). A more recent report among third-generation participants in the Framingham Heart Study similarly described inverse associations between NT-proBNP and visceral fat in a multivariable adjusted analysis including BMI, with no independent association seen with abdominal subcutaneous fat (26).…”

Section: Discussionmentioning

confidence: 99%

Higher Natriuretic Peptide Levels Associate With a Favorable Adipose Tissue Distribution Profile

Neeland¹,

Winders

Ayers³

et al. 2013

Journal of the American College of Cardiology

110

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Objectives To investigate the association between natriuretic peptides and body fat distribution in a multiethnic cohort. Background Natriuretic peptides stimulate lipolysis, reduce weight gain, and promote adipocyte browning in animal models but data are lacking in humans. Methods 2619 participants without heart failure in the Dallas Heart Study underwent measurements of 1) B-type natriuretic peptide (BNP) and NT-proBNP and 2) body fat distribution by dual energy x-ray absorptiometry and magnetic resonance imaging. Cross-sectional associations of natriuretic peptides with adiposity phenotypes were examined after adjustment for age, sex, race, comorbidities, and body mass index. Results Median BNP and NT-proBNP levels in the study cohort (mean age 44 years, 56% women, 48% African-Americans, 32% obese) were 3.0 and 28.1 pg/mL, respectively. Natriuretic peptide levels above the median were associated with a more favorable body fat profile and less insulin resistance including lower visceral fat, liver fat, and HOMA-IR; and more lower body fat and higher adiponectin (p<0.05 for each). In multivariable analyses, NT-proBNP remained inversely associated with visceral (β= −0.08, p<0.0001) and liver fat (β= −0.14, p<0.0001) and positively associated with lower body fat (β= 0.07, p<0.0001) independent of age, sex, race, and obesity-status; findings were similar with BNP. Adjustment for body composition, HOMA-IR, circulating androgens, and adipocytokines did not attenuate the associations. Conclusions Higher natriuretic peptide levels were independently associated with a favorable adiposity profile, characterized by decreased visceral and liver fat and increased lower body fat, suggesting a link between the heart and adipose tissue distribution mediated through natriuretic peptides.

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Section: Discussionmentioning

confidence: 99%

Higher Natriuretic Peptide Levels Associate With a Favorable Adipose Tissue Distribution Profile

Neeland¹,

Winders

Ayers³

et al. 2013

Journal of the American College of Cardiology

110

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“…15 However, the role of fat depots on natriuretic peptide levels in ambulatory adults has not been investigated previously. The results of our analysis in a large community-based sample suggest that the distribution of adiposity contributes to variation in natriuretic peptide levels, with fat in the visceral compartment being a stronger correlate than subcutaneous fat.…”

Section: Discussionmentioning

confidence: 99%

Relation of Visceral Adiposity to Circulating Natriuretic Peptides in Ambulatory Individuals

Cheng

Fox

Larson

et al. 2011

The American Journal of Cardiology

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Natriuretic peptides have important roles in the regulation of vasomotor tone, salt homeostasis, and ventricular remodeling. Lower natriuretic peptide levels observed in obese individuals may underlie the greater cardiovascular risk associated with obesity. Thus, the aim of this study was to determine whether lower natriuretic peptide levels in obesity are attributable to differences in regional fat distribution. We investigated the relationship of plasma N-terminal pro-B-type natriuretic peptide (N-BNP) with regional adiposity in 1,873 community-based individuals (46% women; mean age 45 years). Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were measured by multi-detector computed tomography. In sex-specific, multivariable analyses adjusting for age and blood pressure, log N-BNP was inversely associated with VAT in both men (β −0.11, P<0.001) and women (β −0.19, P<0.001). Log N-BNP was inversely associated with SAT in women only (β −0.14, P<0.001). In models containing both VAT and SAT, only VAT was significantly associated with log N-BNP (men, β −0.137, P<0.001; women, β −0.184, P<0.001). VAT remained associated with log N-BNP even after adjustment for body mass index and waist circumference (β −0.119, P<0.001), and in analyses restricted to non-obese individuals (β −0.114; P<0.001). Adjustment for insulin resistance attenuated the associations of N-BNP with both VAT and SAT. In conclusion, this study demonstrates that circulating N-BNP is related to variation in regional and particularly visceral adiposity. These findings suggest that excess visceral adiposity and concomitant hyperinsulinemia may contribute to the natriuretic peptide “deficiency” observed in obesity.

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“…Evidence from several epidemiological studies demonstrated an inverse association between systemic NP levels (both ANP and BNP) and body weight (mostly expressed by body mass index [BMI]) (21,23,(88)(89)(90)(91)(92). The inverse relationship between NP levels and BMI was also found in the presence of left ventricular hypertrophy (93).…”

Section: Systemic Natriuretic Peptide Deficiency In Obesity Insulin mentioning

confidence: 99%

Natriuretic peptides in the control of lipid metabolism and insulin sensitivity

et al. 2017

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Natriuretic peptides have long been known for their cardiovascular function. However, a growing body of evidence emphasizes the role of natriuretic peptides in human substrate and energy metabolism, thereby connecting the heart with several insulin-sensitive organs like adipose tissue, skeletal muscle and liver. Obesity may be associated with an impaired regulation of the natriuretic peptide system, also indicated as a natriuretic handicap. Evidence points towards a contribution of this natriuretic handicap to the development of obesity, type 2 diabetes mellitus and cardiometabolic complications, although the causal relationship is not fully understood. Nevertheless, targeting the natriuretic peptide pathway may improve metabolic health in obesity and type 2 diabetes mellitus. This review will focus on current literature regarding the metabolic roles of natriuretic peptides with emphasis on lipid metabolism and insulin sensitivity. Furthermore, it will be discussed how exercise and lifestyle intervention may modulate the natriuretic peptide-related metabolic effects.

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Visceral fat is negatively associated with B-type natriuretic peptide levels in patients with advanced type 2 diabetes

Cited by 18 publications

References 21 publications

Higher Natriuretic Peptide Levels Associate With a Favorable Adipose Tissue Distribution Profile

Higher Natriuretic Peptide Levels Associate With a Favorable Adipose Tissue Distribution Profile

Relation of Visceral Adiposity to Circulating Natriuretic Peptides in Ambulatory Individuals

Natriuretic peptides in the control of lipid metabolism and insulin sensitivity

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