doi: 10.1161/CIRCULATIONAHA.105.555573
(Circulation. 2005;112:2163-2168.)
© 2005 American Heart Association, Inc.
Imaging |
Impact of Body Mass and Body Composition on Circulating Levels of Natriuretic Peptides
Results From the Dallas Heart Study
From the Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Tex.
Correspondence to Sandeep R. Das, MD, MPH, Southwestern Medical School, MC 9034, 5323 Harry Hines Blvd, Dallas, TX 75390-9034. E-mail sandeep.das{at}utsouthwestern.edu
Received February 1, 2005; de novo received April 14, 2005; revision received July 8, 2005; accepted July 15, 2005.
Background— The association between higher body mass index (BMI) and lower B-type natriuretic peptide (BNP) level is thought to be mediated by expression of the natriuretic peptide clearance receptor (NPR-C) in adipose tissue. To explore this association, we tested 2 hypotheses: (1) that N-terminal (NT)-proBNP, which is not believed to bind NPR-C, would not be associated with BMI and (2) that lower BNP would be more closely associated with fat mass than with lean mass.
Methods and Results— Measurements of BNP, NT-proBNP, and body composition by direct dual energy x-ray absorptiometry (DEXA) were performed in 2707 subjects from the Dallas Heart Study. The associations between obesity and low BNP (<4 ng/L) or low NT-proBNP (lowest sex-specific quartile) were evaluated with multivariable logistic regression models stratified by sex and adjusted for age, race/ethnicity, hypertension, left ventricular mass, and end-diastolic volume. Higher BMI was independently associated with lower BNP and NT-proBNP (all P<0.001). When BMI was replaced with both DEXA-derived lean and fat mass, greater lean mass, but not fat mass, was associated with low BNP and NT-proBNP levels.
Conclusions— In a large, population-based cohort, we confirm the previously described association between higher BMI and lower BNP and demonstrate a similar inverse association between BMI and NT-proBNP. Interestingly, both BNP and NT-proBNP are more closely associated with lean mass than with fat mass. These findings do not support the hypothesis that the lower BNP levels seen in obesity are driven by enhanced BNP clearance mediated via NPR-C.
Key Words: natriuretic peptides • obesity • hormones • physiology
This article has been cited by other articles:
 |
|
 |
|
  M. Zeller, P. G. Steg, J. Ravisy, L. Lorgis, Y. Laurent, P. Sicard, L. Janin-Manificat, J.-C. Beer, H. Makki, A.-C. Lagrost, et al. Relation Between Body Mass Index, Waist Circumference, and Death After Acute Myocardial Infarction Circulation, July 29, 2008; 118(5): 482 - 490. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. W. Waldo, J. Beede, S. Isakson, S. Villard-Saussine, J. Fareh, P. Clopton, R. L. Fitzgerald, and A. S. Maisel Pro-B-Type Natriuretic Peptide Levels in Acute Decompensated Heart Failure J. Am. Coll. Cardiol., May 13, 2008; 51(19): 1874 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. D. Abel, S. E. Litwin, and G. Sweeney Cardiac Remodeling in Obesity Physiol Rev, April 1, 2008; 88(2): 389 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Daniels and A. S. Maisel Natriuretic Peptides J. Am. Coll. Cardiol., December 18, 2007; 50(25): 2357 - 2368. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Codognotto, A. Piccoli, M. Zaninotto, M. Mion, M. Plebani, U. Vertolli, F. Tona, L. Ruzza, A. Barchita, and G. M. Boffa Renal Dysfunction Is a Confounder for Plasma Natriuretic Peptides in Detecting Heart Dysfunction in Uremic and Idiopathic Dilated Cardiomyopathies Clin. Chem., December 1, 2007; 53(12): 2097 - 2104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Schou, F. Gustafsson, C. N. Kistorp, P. Corell, A. Kjaer, and P. R. Hildebrandt Effects of Body Mass Index and Age on N-Terminal Pro Brain Natriuretic Peptide Are Associated with Glomerular Filtration Rate in Chronic Heart Failure Patients Clin. Chem., November 1, 2007; 53(11): 1928 - 1935. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Zirlik, S. M. Abdullah, N. Gerdes, L. MacFarlane, U. Schonbeck, A. Khera, D. K. McGuire, G. L. Vega, S. Grundy, P. Libby, et al. Interleukin-18, the Metabolic Syndrome, and Subclinical Atherosclerosis: Results From the Dallas Heart Study Arterioscler. Thromb. Vasc. Biol., September 1, 2007; 27(9): 2043 - 2049. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Wang, M. G. Larson, M. J. Keyes, D. Levy, E. J. Benjamin, and R. S. Vasan Association of Plasma Natriuretic Peptide Levels With Metabolic Risk Factors in Ambulatory Individuals Circulation, March 20, 2007; 115(11): 1345 - 1353. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Bayes-Genis, D. M. Lloyd-Jones, R. R. J. van Kimmenade, J. G. Lainchbury, A. M. Richards, J. Ordonez-Llanos, M. Santalo, Y. M. Pinto, and J. L. Januzzi Jr Effect of Body Mass Index on Diagnostic and Prognostic Usefulness of Amino-Terminal Pro-Brain Natriuretic Peptide in Patients With Acute Dyspnea Arch Intern Med, February 26, 2007; 167(4): 400 - 407. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Y. Chang, S. M. Abdullah, T. Jain, H. G. Stanek, S. R. Das, D. K. McGuire, R. J. Auchus, and J. A. de Lemos Associations Among Androgens, Estrogens, and Natriuretic Peptides in Young Women: Observations From the Dallas Heart Study J. Am. Coll. Cardiol., November 7, 2006; (2006) j.jacc.2006.10.040v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. M. Felker, J. W. Petersen, and D. B. Mark Natriuretic peptides in the diagnosis and management of heart failure. Can. Med. Assoc. J., September 12, 2006; 175(6): 611 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. W. Wallace, S. M. Abdullah, M. H. Drazner, S. R. Das, A. Khera, D. K. McGuire, F. Wians, M. S. Sabatine, D. A. Morrow, and J. A. de Lemos Prevalence and Determinants of Troponin T Elevation in the General Population Circulation, April 25, 2006; 113(16): 1958 - 1965. [Abstract] [Full Text] [PDF]
|
|