The associations between metabolic variables and NT-proBNP are blunted at pathological ranges: The Multi-Ethnic Study of Atherosclerosis

Otto A. Sanchez; Daniel A. Duprez; Hossein Bahrami; Lori B. Daniels; Aaron R. Folsom; Joao A. Lima; Alan Maisel; Carmen A. Peralta; David R. Jacobs

doi:10.1016/j.metabol.2013.11.017

The associations between metabolic variables and NT-proBNP are blunted at pathological ranges: The Multi-Ethnic Study of Atherosclerosis

Otto A. Sanchez, Daniel A. Duprez, Hossein Bahrami, Lori B. Daniels, Aaron R. Folsom, Joao A. Lima, Alan Maisel, Carmen A. Peralta, David R. Jacobs

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective Under physiological conditions brain natriuretic peptide (BNP) is inversely associated with metabolic risk factors, but under pathological conditions these associations may tend to plateau. Material and methods 5597 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA), 45-84 years of age, free of overt cardiovascular disease in 2000-02 and then again in 2003-05 participated in this study. Associations between NT-proBNP and BMI, blood lipids, homeostasis model of insulin resistance (HOMA-IR) using linear regression models were adjusted for age, race, sex, BMI, % of energy from saturated fats, intentional exercise, statin use, antihypertensive medication use, diabetes and glomerular filtration rate. The inflection points (IP) at which these associations became nonlinear were determined using linear splines with knots at different levels of NT-proBNP. Results Participants with NT-proBNP ≥ 100 pg/mL (29%) tended to be older, on statins and anti-hypertensive medications vs. those with NT-proBNP < 100 pg/mL. The IP point varies among variables and ranged from 50-120 pg/mL. NT-proBNP < IP, associated inversely with BMI, total cholesterol (TC), LDL-C, triglycerides (TG) and HOMA-IR, but positively with HDL-C. A higher proportion of participants with NT-proBNP ≥ 100 pg/mL had subclinical CVD. All associations with NT-proBNP plateaued when NT-proBNP ≥ IP. Baseline level in NT-proBNP was not associated with 3-year change in BMI, TG, HDL-C or fasting glucose. Conclusions In a large cardiovascular disease-free cohort, NT-proBNP within the lower (physiological) range was inversely associated with TC, LDL-C, TG and insulin resistance with different inflection points, but at higher (pathological) levels these associations were blunted.

Original language	English (US)
Pages (from-to)	475-483
Number of pages	9
Journal	Metabolism: clinical and experimental
Volume	63
Issue number	4
DOIs	https://doi.org/10.1016/j.metabol.2013.11.017
State	Published - Apr 2014

Bibliographical note

Funding Information:
This research was supported by contracts N01-HC-95159 through N01-HC-95165, N01-HC-95169 grants R01-HL 66075, N01-HC-95168, N01-HC 9808, and N01-HC 95168 from the National Heart, Lung, and Blood Institute. The authors also thank the investigators and staff of the Multi-Ethnic Study of Atherosclerosis (MESA) for their valuable contributions. A full list of MESA investigators and institutions can be found at http://www.mesa-nhlbi.org/ .

Keywords

BMI
HOMA
Inflammatory markers
Lipids
NT-proBNP

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Sanchez, O. A., Duprez, D. A., Bahrami, H., Daniels, L. B., Folsom, A. R., Lima, J. A., Maisel, A., Peralta, C. A., & Jacobs, D. R. (2014). The associations between metabolic variables and NT-proBNP are blunted at pathological ranges: The Multi-Ethnic Study of Atherosclerosis. Metabolism: clinical and experimental, 63(4), 475-483. https://doi.org/10.1016/j.metabol.2013.11.017

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abstract = "Objective Under physiological conditions brain natriuretic peptide (BNP) is inversely associated with metabolic risk factors, but under pathological conditions these associations may tend to plateau. Material and methods 5597 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA), 45-84 years of age, free of overt cardiovascular disease in 2000-02 and then again in 2003-05 participated in this study. Associations between NT-proBNP and BMI, blood lipids, homeostasis model of insulin resistance (HOMA-IR) using linear regression models were adjusted for age, race, sex, BMI, % of energy from saturated fats, intentional exercise, statin use, antihypertensive medication use, diabetes and glomerular filtration rate. The inflection points (IP) at which these associations became nonlinear were determined using linear splines with knots at different levels of NT-proBNP. Results Participants with NT-proBNP ≥ 100 pg/mL (29%) tended to be older, on statins and anti-hypertensive medications vs. those with NT-proBNP < 100 pg/mL. The IP point varies among variables and ranged from 50-120 pg/mL. NT-proBNP < IP, associated inversely with BMI, total cholesterol (TC), LDL-C, triglycerides (TG) and HOMA-IR, but positively with HDL-C. A higher proportion of participants with NT-proBNP ≥ 100 pg/mL had subclinical CVD. All associations with NT-proBNP plateaued when NT-proBNP ≥ IP. Baseline level in NT-proBNP was not associated with 3-year change in BMI, TG, HDL-C or fasting glucose. Conclusions In a large cardiovascular disease-free cohort, NT-proBNP within the lower (physiological) range was inversely associated with TC, LDL-C, TG and insulin resistance with different inflection points, but at higher (pathological) levels these associations were blunted.",

keywords = "BMI, HOMA, Inflammatory markers, Lipids, NT-proBNP",

author = "Sanchez, {Otto A.} and Duprez, {Daniel A.} and Hossein Bahrami and Daniels, {Lori B.} and Folsom, {Aaron R.} and Lima, {Joao A.} and Alan Maisel and Peralta, {Carmen A.} and Jacobs, {David R.}",

note = "Funding Information: This research was supported by contracts N01-HC-95159 through N01-HC-95165, N01-HC-95169 grants R01-HL 66075, N01-HC-95168, N01-HC 9808, and N01-HC 95168 from the National Heart, Lung, and Blood Institute. The authors also thank the investigators and staff of the Multi-Ethnic Study of Atherosclerosis (MESA) for their valuable contributions. A full list of MESA investigators and institutions can be found at http://www.mesa-nhlbi.org/ .",

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T1 - The associations between metabolic variables and NT-proBNP are blunted at pathological ranges

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Sanchez, Otto A.

AU - Duprez, Daniel A.

AU - Bahrami, Hossein

AU - Daniels, Lori B.

AU - Folsom, Aaron R.

AU - Lima, Joao A.

AU - Maisel, Alan

AU - Peralta, Carmen A.

AU - Jacobs, David R.

N1 - Funding Information: This research was supported by contracts N01-HC-95159 through N01-HC-95165, N01-HC-95169 grants R01-HL 66075, N01-HC-95168, N01-HC 9808, and N01-HC 95168 from the National Heart, Lung, and Blood Institute. The authors also thank the investigators and staff of the Multi-Ethnic Study of Atherosclerosis (MESA) for their valuable contributions. A full list of MESA investigators and institutions can be found at http://www.mesa-nhlbi.org/ .

PY - 2014/4

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N2 - Objective Under physiological conditions brain natriuretic peptide (BNP) is inversely associated with metabolic risk factors, but under pathological conditions these associations may tend to plateau. Material and methods 5597 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA), 45-84 years of age, free of overt cardiovascular disease in 2000-02 and then again in 2003-05 participated in this study. Associations between NT-proBNP and BMI, blood lipids, homeostasis model of insulin resistance (HOMA-IR) using linear regression models were adjusted for age, race, sex, BMI, % of energy from saturated fats, intentional exercise, statin use, antihypertensive medication use, diabetes and glomerular filtration rate. The inflection points (IP) at which these associations became nonlinear were determined using linear splines with knots at different levels of NT-proBNP. Results Participants with NT-proBNP ≥ 100 pg/mL (29%) tended to be older, on statins and anti-hypertensive medications vs. those with NT-proBNP < 100 pg/mL. The IP point varies among variables and ranged from 50-120 pg/mL. NT-proBNP < IP, associated inversely with BMI, total cholesterol (TC), LDL-C, triglycerides (TG) and HOMA-IR, but positively with HDL-C. A higher proportion of participants with NT-proBNP ≥ 100 pg/mL had subclinical CVD. All associations with NT-proBNP plateaued when NT-proBNP ≥ IP. Baseline level in NT-proBNP was not associated with 3-year change in BMI, TG, HDL-C or fasting glucose. Conclusions In a large cardiovascular disease-free cohort, NT-proBNP within the lower (physiological) range was inversely associated with TC, LDL-C, TG and insulin resistance with different inflection points, but at higher (pathological) levels these associations were blunted.

AB - Objective Under physiological conditions brain natriuretic peptide (BNP) is inversely associated with metabolic risk factors, but under pathological conditions these associations may tend to plateau. Material and methods 5597 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA), 45-84 years of age, free of overt cardiovascular disease in 2000-02 and then again in 2003-05 participated in this study. Associations between NT-proBNP and BMI, blood lipids, homeostasis model of insulin resistance (HOMA-IR) using linear regression models were adjusted for age, race, sex, BMI, % of energy from saturated fats, intentional exercise, statin use, antihypertensive medication use, diabetes and glomerular filtration rate. The inflection points (IP) at which these associations became nonlinear were determined using linear splines with knots at different levels of NT-proBNP. Results Participants with NT-proBNP ≥ 100 pg/mL (29%) tended to be older, on statins and anti-hypertensive medications vs. those with NT-proBNP < 100 pg/mL. The IP point varies among variables and ranged from 50-120 pg/mL. NT-proBNP < IP, associated inversely with BMI, total cholesterol (TC), LDL-C, triglycerides (TG) and HOMA-IR, but positively with HDL-C. A higher proportion of participants with NT-proBNP ≥ 100 pg/mL had subclinical CVD. All associations with NT-proBNP plateaued when NT-proBNP ≥ IP. Baseline level in NT-proBNP was not associated with 3-year change in BMI, TG, HDL-C or fasting glucose. Conclusions In a large cardiovascular disease-free cohort, NT-proBNP within the lower (physiological) range was inversely associated with TC, LDL-C, TG and insulin resistance with different inflection points, but at higher (pathological) levels these associations were blunted.

KW - BMI

KW - HOMA

KW - Inflammatory markers

KW - Lipids

KW - NT-proBNP

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The associations between metabolic variables and NT-proBNP are blunted at pathological ranges: The Multi-Ethnic Study of Atherosclerosis

Abstract

Bibliographical note

Keywords

UN SDGs

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