Advanced

Cardiac Natriuretic Peptides, Obesity, and Insulin Resistance: Evidence from Two Community-Based Studies.

Khan, Abigail May; Cheng, Susan; Magnusson, Martin LU ; Larson, Martin G; Newton-Cheh, Christopher; McCabe, Elizabeth L; Coviello, Andrea D; Florez, Jose C; Fox, Caroline S and Levy, Daniel, et al. (2011) In The Journal of clinical endocrinology and metabolism 96(10). p.3242-3249
Abstract
Background: The natriuretic peptides play an important role in salt homeostasis and blood pressure regulation. It has been suggested that obesity promotes a relative natriuretic peptide deficiency, but this has been a variable finding in prior studies and the cause is unknown. Aim: The aim of this study was to examine the association between obesity and natriuretic peptide levels and evaluate the role of hyperinsulinemia and testosterone as mediators of this interaction. Methods: We studied 7770 individuals from the Framingham Heart Study (n = 3833, 54% women) and the Malmö Diet and Cancer study (n = 3918, 60% women). We examined the relation of plasma N-terminal pro-B-type natriuretic peptide levels (N-BNP) with obesity, insulin... (More)
Background: The natriuretic peptides play an important role in salt homeostasis and blood pressure regulation. It has been suggested that obesity promotes a relative natriuretic peptide deficiency, but this has been a variable finding in prior studies and the cause is unknown. Aim: The aim of this study was to examine the association between obesity and natriuretic peptide levels and evaluate the role of hyperinsulinemia and testosterone as mediators of this interaction. Methods: We studied 7770 individuals from the Framingham Heart Study (n = 3833, 54% women) and the Malmö Diet and Cancer study (n = 3918, 60% women). We examined the relation of plasma N-terminal pro-B-type natriuretic peptide levels (N-BNP) with obesity, insulin resistance, and various metabolic subtypes. Results: Obesity was associated with 6-20% lower levels of N-BNP (P < 0.001 in Framingham, P = 0.001 in Malmö), whereas insulin resistance was associated with 10-30% lower levels of N-BNP (P < 0.001 in both cohorts). Individuals with obesity who were insulin sensitive had only modest reductions in N-BNP compared with nonobese, insulin-sensitive individuals. On the other hand, individuals who were nonobese but insulin resistant had 26% lower N-BNP in Framingham (P < 0.001) and 10% lower N-BNP in Malmö (P < 0.001), compared with nonobese and insulin-sensitive individuals. Adjustment for serum-free testosterone did not alter these associations. Conclusions: In both nonobese and obese individuals, insulin resistance is associated with lower natriuretic peptide levels. The relative natriuretic peptide deficiency seen in obesity could be partly attributable to insulin resistance, and could be one mechanism by which insulin resistance promotes hypertension. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Journal of clinical endocrinology and metabolism
volume
96
issue
10
pages
3242 - 3249
publisher
The Endocrine Society
external identifiers
  • wos:000295879600062
  • pmid:21849523
  • scopus:80053532134
ISSN
1945-7197
DOI
10.1210/jc.2011-1182
language
English
LU publication?
yes
id
cfbc4fe6-542a-4882-abab-22e383ff19a2 (old id 2150901)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21849523?dopt=Abstract
date added to LUP
2011-09-04 22:19:36
date last changed
2017-10-22 04:04:33
@article{cfbc4fe6-542a-4882-abab-22e383ff19a2,
  abstract     = {Background: The natriuretic peptides play an important role in salt homeostasis and blood pressure regulation. It has been suggested that obesity promotes a relative natriuretic peptide deficiency, but this has been a variable finding in prior studies and the cause is unknown. Aim: The aim of this study was to examine the association between obesity and natriuretic peptide levels and evaluate the role of hyperinsulinemia and testosterone as mediators of this interaction. Methods: We studied 7770 individuals from the Framingham Heart Study (n = 3833, 54% women) and the Malmö Diet and Cancer study (n = 3918, 60% women). We examined the relation of plasma N-terminal pro-B-type natriuretic peptide levels (N-BNP) with obesity, insulin resistance, and various metabolic subtypes. Results: Obesity was associated with 6-20% lower levels of N-BNP (P &lt; 0.001 in Framingham, P = 0.001 in Malmö), whereas insulin resistance was associated with 10-30% lower levels of N-BNP (P &lt; 0.001 in both cohorts). Individuals with obesity who were insulin sensitive had only modest reductions in N-BNP compared with nonobese, insulin-sensitive individuals. On the other hand, individuals who were nonobese but insulin resistant had 26% lower N-BNP in Framingham (P &lt; 0.001) and 10% lower N-BNP in Malmö (P &lt; 0.001), compared with nonobese and insulin-sensitive individuals. Adjustment for serum-free testosterone did not alter these associations. Conclusions: In both nonobese and obese individuals, insulin resistance is associated with lower natriuretic peptide levels. The relative natriuretic peptide deficiency seen in obesity could be partly attributable to insulin resistance, and could be one mechanism by which insulin resistance promotes hypertension.},
  author       = {Khan, Abigail May and Cheng, Susan and Magnusson, Martin and Larson, Martin G and Newton-Cheh, Christopher and McCabe, Elizabeth L and Coviello, Andrea D and Florez, Jose C and Fox, Caroline S and Levy, Daniel and Robins, Sander J and Arora, Pankaj and Bhasin, Shalender and Lam, Carolyn S P and Vasan, Ramachandran S and Melander, Olle and Wang, Thomas J},
  issn         = {1945-7197},
  language     = {eng},
  number       = {10},
  pages        = {3242--3249},
  publisher    = {The Endocrine Society},
  series       = {The Journal of clinical endocrinology and metabolism},
  title        = {Cardiac Natriuretic Peptides, Obesity, and Insulin Resistance: Evidence from Two Community-Based Studies.},
  url          = {http://dx.doi.org/10.1210/jc.2011-1182},
  volume       = {96},
  year         = {2011},
}