natriuretic-peptide--brain and Metabolic-Syndrome

Investigations into the mixed muscle-secretory phenotype of cardiomyocytes from the atrial appendages of the heart led to the discovery that these cells produce, in a regulated manner, two polypeptide hormones - the natriuretic peptides - referred to as atrial natriuretic factor or atrial natriuretic peptide (ANP) and brain or B-type natriuretic peptide (BNP), thereby demonstrating an endocrine function for the heart. Studies on the gene encoding ANP (NPPA) initiated the field of modern research into gene regulation in the cardiovascular system. Additionally, ANP and BNP were found to be the natural ligands for cell membrane-bound guanylyl cyclase receptors that mediate the effects of natriuretic peptides through the generation of intracellular cGMP, which interacts with specific enzymes and ion channels. Natriuretic peptides have many physiological actions and participate in numerous pathophysiological processes. Important clinical entities associated with natriuretic peptide research include heart failure, obesity and systemic hypertension. Plasma levels of natriuretic peptides have proven to be powerful diagnostic and prognostic biomarkers of heart disease. Development of pharmacological agents that are based on natriuretic peptides is an area of active research, with vast potential benefits for the treatment of cardiovascular disease.

Topics: Animals; Atrial Appendage; Atrial Fibrillation; Atrial Natriuretic Factor; Atrial Remodeling; Biomarkers; Cyclic GMP; Diabetes Mellitus; Fibrosis; Gene Expression Regulation, Developmental; Heart Atria; Heart Failure; Humans; Hypertension; Lipid Metabolism; Metabolic Syndrome; Mice; Myocardium; Myocytes, Cardiac; Natriuretic Peptide, Brain; Obesity; Peptide Fragments; Prognosis; Protein Processing, Post-Translational; Pulmonary Arterial Hypertension; Receptors, Guanylate Cyclase-Coupled; Secretory Vesicles; Ventricular Remodeling; Water-Electrolyte Balance

Obesity is a major risk factor for the development of chronic heart failure (CHF) and does not only pose diagnostic challenges, but also has prognostic implications for these patients. Paradoxically, obese patients with CHF have a better prognosis than thinner individuals. In recent years, it has been demonstrated that the adipose tissue, even in patients with HF, is not always detrimental, and that obesity may coexist with a phenotype of benign adiposity without systemic metabolic abnormalities. Experimental data have shown that natriuretic peptides (NPs), and in particular brain natriuretic peptide (BNP), play a major role in the communication of the heart with the adipose tissue. Body fat distribution and adipose tissue function show a large degree of heterogeneity among depots and may explain the complex relationship between NPs and body fat. NPs can affect both the quality and the behaviour of fatty tissue, promoting a healthy adipocyte phenotype, and can favourably affect body fat metabolism. In this article, we review the existing literature on the bidirectional effects of BNP and adipose tissue in HF and highlight the complexity of this relationship.

Topics: Adipose Tissue; Adiposity; Body Fat Distribution; Heart Failure; Humans; Hypertension; Hypertrophy, Left Ventricular; Metabolic Syndrome; Natriuretic Peptide, Brain; Obesity; Phenotype; Prevalence; Prognosis; Risk Factors

Posttraumatic stress disorder (PTSD) is a chronic condition related to severe stress and trauma. There is a mounting evidence about increased prevalence and mortality from cardiovascular diseases (CVD) in patients with PTSD. This review summarizes the current data on possible relations between PTSD and increased risks of CVD, including biological, psychological and behavioral factors. Biological factors refer to increased prevalence of metabolic syndrome (MetS), hypertension, elevation of pro-inflammatory cytokines and homocysteine levels. Peripheral Brain-derived neurotropic factor (BDNF), serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and quantitative electroencephalogram (qEEG) are promising surrogate markers of increased cardiovascular risk. Among psychological factors, some personality traits, such as neuroticism and trait impulsivity/hostility, contribute to the development of PTSD, and are associated with general cardiovascular distress. Recently, type-D (distressed) personality is usually investigated in relation to cardiovascular morbidity, but in populations other than PTSD patients. Behavioral factors refer to unhealthy life-styles, encompassing high smoking rate, drug substances abuse and addiction, physical inactivity and unhealthy diet. The relationships among all these factors are complex and yet incompletely taken into consideration. Because of a high prevalence of CVD in patients with PTSD, there is a strong need for a more intensive focus on this vulnerable population in both primary and secondary cardiovascular prevention as well as in effective treatment possibilities.

Topics: Cardiovascular Diseases; Character; Female; Health Behavior; Humans; Metabolic Syndrome; Natriuretic Peptide, Brain; Peptide Fragments; Resilience, Psychological; Risk; Risk Factors; Stress Disorders, Post-Traumatic; Survival Rate; Type D Personality

Cardiovascular disease (CVD), including coronary heart disease and stroke, is the leading cause of death among U.S. women and men. Established cardiovascular risk factors such as smoking, diabetes, hypertension, and elevated total cholesterol, and risk prediction models based on such factors, perform well but do not perfectly predict future risk of CVD. Thus, there has been much recent interest among cardiovascular researchers in identifying novel biomarkers to aid in risk prediction. Such markers include alternative lipids, B-type natriuretic peptides, high-sensitivity troponin, coronary artery calcium, and genetic markers. This article reviews the role of traditional cardiovascular risk factors, risk prediction tools, and selected novel biomarkers and other exposures in predicting risk of developing CVD in women. The predictive role of novel cardiovascular biomarkers for women in primary prevention settings requires additional study, as does the diagnostic and prognostic utility of cardiac troponins for acute coronary syndromes in clinical settings. Sex differences in the clinical expression and physiology of metabolic syndrome may have implications for cardiovascular outcomes. Consideration of exposures that are unique to, or more prevalent in, women may also help to refine cardiovascular risk estimates in this group.

Topics: Apolipoprotein A-I; Apolipoproteins B; Biomarkers; Body Fat Distribution; Calcium; Cardiovascular Diseases; Female; Humans; Lipoprotein(a); Male; Metabolic Syndrome; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Primary Prevention; Risk Assessment; Risk Factors; Troponin T

Cardiovascular disease is the leading cause of death amongst women worldwide. Cardiovascular risk assessment and primary prevention are important strategies to improve morbidity and mortality. In additional to the traditional risk factors, pregnancy complications such as pre-eclampsia and gestational diabetes increment future risk of developing cardiovascular complications. Additionally, several serum biomarkers are valuable measures for both risk assessment and predictors of clinical outcomes in women. The purpose of this review is to describe current risk stratification schemes as well as outline the role of obstetric history and serum biomarkers in adjusting risk stratification in women.

Topics: Adult; Biomarkers; C-Reactive Protein; Cardiovascular Diseases; Female; Humans; Hypertension; Lipids; Metabolic Syndrome; Natriuretic Peptide, Brain; Obesity; Pregnancy; Primary Prevention; Risk Assessment; Risk Factors; Risk Reduction Behavior; Sedentary Behavior; Smoking; United States; Women's Health

Topics: Ankle Brachial Index; Anti-Obesity Agents; Arteriosclerosis; Biomarkers; C-Reactive Protein; Calcinosis; Coronary Disease; Diabetes Mellitus; Diagnostic Imaging; Dyslipidemias; Endarterectomy; Fibrinolytic Agents; Genetic Markers; Glycated Hemoglobin; Health Behavior; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Inflammation; Life Style; Lipids; Metabolic Syndrome; Natriuretic Peptide, Brain; Obesity; Risk Assessment; Risk Factors; Smoking Cessation; Stents; Stroke; Thrombosis; Troponin I

To evaluate the effects of canrenone compared to placebo on blood pressure control, some non-conventional biomarkers in cardiovascular stratification, and on metalloproteinases in patients affected by metabolic syndrome.. A total of 156 Caucasian patients were treated with placebo or canrenone, 50 mg once a day, for 3 months and then 50 mg twice a day, till the end of the study. We evaluated: systolic (SBP) and diastolic blood pressure (DBP), body weight, body mass index (BMI), fasting plasma glucose (FPG), lipid profile, plasma aldosterone, creatinine, potassium, brain natriuretic peptide (BNP), metalloproteinases 2 and 9 (MMP-2 and -9), lipoprotein (a) (Lp(a)), and serum myeloperoxidase (MPO).. We observed a significant decrease of SBP and DBP in the canrenone group compared to baseline. Canrenone gave a significant decrease of MMP-2 and -9, Lp(a), and MPO compared to baseline, not observed with placebo. Plasma aldosterone, but not BNP, decreased with canrenone, both compared to baseline and to placebo.. Canrenone seems to be effective in reducing blood pressure in patients with metabolic syndrome. Moreover, canrenone seems also to improve MPO, Lp(a), and metalloproteinases in these patients.

Topics: Aged; Aldosterone; Biomarkers; Blood Glucose; Blood Pressure; Body Mass Index; Body Weight; Canrenone; Creatine; Double-Blind Method; Fasting; Female; Humans; Inflammation; Lipids; Lipoproteins; Male; Metabolic Syndrome; Metalloproteases; Middle Aged; Natriuretic Peptide, Brain; Peroxidase; Potassium; White People

Metabolic syndrome is becoming a common disease due to a rise in obesity rates among adults.. The aim was to evaluate the effects of canrenone compared to placebo on metabolic and inflammatory parameters in patients affected by metabolic syndrome. A total of 145 patients were treated with placebo or canrenone, 50 mg/day, for 3 months and then 50 mg b.i.d. till the end of the study. Blood pressure, body weight, body mass index, fasting plasma glucose (FPG), fasting plasma insulin, HOMA-IR, lipid profile, plasma aldosterone, brain natriuretic peptide, high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-α (TNF-α) and M value were evaluated.. A decrease of blood pressure was observed in canrenone group compared to baseline; moreover, systolic blood pressure value recorded after 6 months of canrenone therapy was lower than the one recorded with placebo. Canrenone gave a significant decrease of FPI and HOMA index, and an increase of M value both compared to baseline and to placebo. Canrenone also decreased triglycerides and FPG was not observed with placebo. Canrenone also decreased plasma aldosterone, Hs-CRP and TNF-α compared to baseline and to placebo.. Canrenone seems to be effective in reducing some factors involved in metabolic syndrome and in improving insulin-resistance and the inflammatory state observed in these patients.

Topics: Aged; Aldosterone; Blood Glucose; Blood Pressure; C-Reactive Protein; Canrenone; Female; Humans; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Mineralocorticoid Receptor Antagonists; Natriuretic Peptide, Brain; Tumor Necrosis Factor-alpha

We analyzed the effect of the mineralocorticoid receptor antagonist canrenone on LV mechanics in patients with or without metabolic syndrome (MetS) and compensated (Class II NYHA) heart failure (HF) with reduced ejection fraction (EF≤45%) on optimal therapy (including ACE-i or ARB, and β-blockers).. From a randomized, double-blind placebo-controlled trial (AREA-in-CHF), patients with (73 on canrenone [Can] and 77 on placebo [Pla]), based on modified ATPIII definition (BMI≥30kg/m(2) instead of waist girth) or without MetS (146 by arm). In addition to traditional echocardiographic parameters, we also evaluated myocardial mechano-energetic efficiency (MME) based on a previously reported method. At baseline, Can and Pla did not differ in age, BMI, blood pressure (BP), metabolic profile, BNP, and PIIINP. Compared with MetS-Pla, and controlling for age, sex and diabetes, at the final control MetS-Can exhibited increased MME, preserved E/A ratio, and decreased atrial dimensions (0.04

Topics: Aged; Canrenone; Double-Blind Method; Female; Heart Failure, Systolic; Heart Ventricles; Humans; Male; Metabolic Syndrome; Middle Aged; Mineralocorticoid Receptor Antagonists; Natriuretic Peptide, Brain; Peptide Fragments; Placebos; Procollagen

Metabolic syndrome is associated with intravascular inflammation, as determined by increased levels of inflammatory biomarkers and an increased risk of ischemic atherothrombotic events. Evidence suggests that atherothrombosis and intravascular inflammation share predictive biomarkers, including high-sensitivity C-reactive protein, CD40 ligand, P-selectin, and N-terminal pro-brain natriuretic peptide. Patients who had metabolic syndrome were randomized to receive clopidogrel 75 mg/day plus aspirin 81 mg/day (n = 89) or placebo plus aspirin 81 mg/day (n = 92) for 9 weeks to assess the efficacy of each treatment in suppression of inflammatory markers. Change from baseline in the levels of high-sensitivity C-reactive protein, CD40 ligand, P-selectin, and N-terminal pro-brain natriuretic peptide at 6 weeks was assessed to evaluate each treatment. There was a significant difference at Week 6 in model-adjusted CD40-ligand levels in favor of clopidogrel plus aspirin compared with placebo plus aspirin in both the intent-to-treat population (difference between least-squares means = -186.5; 95% confidence interval, -342.3 to -30.8; P = 0.02) and the per-protocol population (P = 0.05). No significant differences were observed between the treatment arms for high-sensitivity C-reactive protein, P-selectin, and N-terminal pro-brain natriuretic peptide. There were no deaths or serious adverse events in either treatment arm. Data from this study suggest that clopidogrel can decrease the expression of the CD40-ligand biomarker.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Aspirin; Atherosclerosis; Biomarkers; C-Reactive Protein; CD40 Ligand; Clopidogrel; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Inflammation Mediators; Least-Squares Analysis; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; P-Selectin; Peptide Fragments; Pilot Projects; Platelet Aggregation Inhibitors; Thrombosis; Ticlopidine; Time Factors; Treatment Outcome; United States; Young Adult

We compared the effects of telmisartan and olmesartan in 20 patients with chronic heart failure and metabolic syndrome. The subjects underwent once-daily 40 mg telmisartan for at least 3 months before switching to once-daily 20 mg olmesartan for the next 3 months (post 1). They were then treated with 3 months of once-daily 40 mg telmisartan (post 2). Systolic and diastolic blood pressure in the early morning, plasma B-type natriuretic peptide, serum total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were increased at post 1 (p < 0.005, p < 0.05, p < 0.05, p < 0.05, p < 0.05, and p < 0.005 vs. baseline, respectively) before returning to their baseline values at post 2. The changes in plasma B-type natriuretic peptide levels correlated significantly with the shifts in systolic and diastolic blood pressure in the early morning at posts 1 and 2. Meanwhile, there were no fluctuations in either blood pressure in the late evening or in the outpatient room; nor were there fluctuations in heart rate. Simultaneously, neither serum high-density lipoprotein cholesterol nor fasting blood sugar levels differed significantly between posts. Moreover, telmisartan had more beneficial effects on glucose and lipid profiles in patients with relatively high HbA1c, serum total and low-density lipoprotein cholesterol, and triglyceride levels. Therefore, we concluded that telmisartan was more beneficial than olmesartan for controlling blood pressure in the early morning, as well as for improving glucose and lipid profiles in patients with hypertension, chronic heart failure, and metabolic syndrome.

Topics: Aged; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Benzimidazoles; Benzoates; Blood Glucose; Blood Pressure; Chronic Disease; Female; Glycated Hemoglobin; Heart Failure; Heart Rate; Humans; Hypertension; Imidazoles; Lipid Metabolism; Lipids; Longitudinal Studies; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Telmisartan; Tetrazoles

Patients with metabolic syndrome are at increased risk for cardiovascular complications. We sought to determine whether peroxisome proliferator-activated receptor gamma agonists had any beneficial effect on patients with metabolic syndrome undergoing percutaneous coronary intervention (PCI).. A total of 200 patients with metabolic syndrome undergoing PCI were randomized to rosiglitazone or placebo and followed for 1 year. Carotid intima-medial thickness (CIMT), inflammatory markers, lipid levels, brain natriuretic peptide, and clinical events were measured at baseline, 6 months, and 12 months.. There was no significant difference in CIMT between the 2 groups. There was no difference in the 12-month composite end point of death, myocardial infarction (MI), stroke, or any recurrent ischemia (31.4% vs 30.2%, P = .99). The rate of death, MI, or stroke at 12 months was numerically lower in the rosiglitazone group (11.9% vs 6.4%, P = .19). There was a trend toward a greater decrease over time in high-sensitivity C-reactive protein values compared with baseline in the group randomized to rosiglitazone versus placebo both at 6 months (-35.4% vs -15.8%, P = .059) and 12 months (-40.0% vs -20.9%, P = .089) and higher change in high-density lipoprotein (+15.5% vs +4.1%, P = .05) and lower triglycerides (-13.9% vs +14.9%, P = .004) in the rosiglitazone arm. There was a trend toward less new onset diabetes in the rosiglitazone group (0% vs 3.3%, P = .081) and no episodes of symptomatic hypoglycemia. There was no excess of new onset of clinical heart failure in the rosiglitazone group, nor was there a significant change in brain natriuretic peptide levels.. Patients with metabolic syndrome presenting for PCI are at increased risk for subsequent cardiovascular events. Rosiglitazone for 12 months did not appear to affect CIMT in this population, although it did have beneficial effects on high-sensitivity C-reactive protein, high-density lipoprotein, and triglycerides. Further study of peroxisome proliferator-activated receptor agonism in patients with metabolic syndrome undergoing PCI may be warranted.

Topics: Angioplasty, Balloon, Coronary; Biomarkers; Cardiovascular Diseases; Coronary Disease; Disease Progression; Double-Blind Method; Female; Humans; Hypoglycemic Agents; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Pilot Projects; PPAR gamma; Rosiglitazone; Thiazolidinediones

Ischemic heart disease (IHD) is the leading cause of death and disability in many countries. The development of IHD is affected by a number of diseases, including metabolic syndrome (MS). Modern predictors of IHD include stimulating growth factor (ST2) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP).. The aim of the study was to investigate serum ST2 and NT-proBNP levels in patients with IHD and in patients with IHD in the setting of MS.. The concentrations levels of ST2 and NTproBNP were investigated using an enzyme-linked immunoassay in 20 patients with verified IHD. 8 patients had IHD without MS (5 males, 3 females) and 10 patients had MS (9 males and 1 female). The mean age of patients was 55 ± 2 years. The control group included 20 virtually healthy, age- and gender-matched individuals.. Serum concentrations of ST2 in patients with IHD in the setting of MS were 31% above normal (p<0.05). In MS-free patients with IHD, serum levels of ST2 were 16% above those in controls (p<0.05). Serum concentration levels of NT-proBNP in patients with IHD in the setting of metabolic syndrome were 62% above normal (p<0.05), while NT-proBNP levels in MS-free patients with IHD were within normal (p>0.05). It was established strong positive correlations between ST2 and NT-proBNP concentration levels (r = 0.90; p<0.05).. Based on the completed analysis of laboratory data, a conclusion can be made that concentrations of ST2 correlates positively with NT-proBNP values in patients with IHD in the setting of MS, which may suggest the presence of ischemic and metabolic disorders in these patients.

Topics: Biomarkers; Female; Humans; Intercellular Signaling Peptides and Proteins; Male; Metabolic Syndrome; Middle Aged; Myocardial Ischemia; Natriuretic Peptide, Brain; Peptide Fragments

This study aimed to investigate the impact of metabolic syndrome (MetS) with microalbuminuria on the improvement of cardiac function after acute myocardial infarction (AMI).. Nondiabetic patients with acute ST segment elevation MI (STEMI) who underwent coronary revascularization from 2013 to 2017 were included. They were grouped according to history of MetS and microalbuminuria test results as follows: microalbuminuria/MetS group, normoalbuminuria/MetS group, microalbuminuria/no MetS group, and normoalbuminuria/no MetS group. Left ventricular ejection fraction (LVEF) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at the 6‑month follow-up were measured and the predictive value of MetS with microalbuminuria on recovery of cardiac function was assessed by multivariable logistic regression modeling.. A total of 530 STEMI patients were included (average age = 66.6 years). Analysis of covariance showed that LVEF recovery in the normoalbuminuria/no MetS group was better than that of the normoalbuminuria/MetS, microalbuminuria/no MetS, and microalbuminuria/MetS groups (49.22% vs. 48.92% vs. 47.48% vs. 46.99%, respectively, p < 0.001) when acute phase LVEF was the covariable. The NT-proBNP level of the normoalbuminuria/no MetS group at the 6‑month follow-up was lower than that of the microalbuminuria/MetS group (p < 0.001). Further regression analysis revealed that there was a lower probability of complete cardiac function recovery after 6 months in patients with microalbuminuria (odds ratio: 0.455) than in patients without microalbuminuria (95% CI: 0.316-0.655, p < 0.001).. Although post-AMI cardiac function in MetS patients with microalbuminuria can be improved after revascularization, the improvement is not as good as that of patients without microalbuminuria, suggesting that clinical attention should be paid to this subgroup.. HINTERGRUND: Ziel der vorliegenden Studie war es, den Einfluss eines metabolischen Syndroms (MetS) mit Mikroalbuminurie auf die Erholung der Herzfunktion nach akutem Myokardinfarkt (AMI) zu untersuchen.. Patienten ohne Diabetes mellitus mit akutem ST-Strecken-Hebungs-Infarkt (STEMI), bei denen zwischen 2013 und 2017 eine Revaskularisierung der Koronarien erfolgte, wurden in die Studie einbezogen. Sie wurden entsprechend ihrer Anamnese in Bezug auf MetS und den Testergebnissen auf Mikroalbuminurie folgendermaßen in Gruppen eingeteilt: Mikroalbuminurie/MetS-Gruppe, Normalbuminurie/MetS-Gruppe, Mikroalbuminurie/kein-MetS-Gruppe und Normalbuminurie/kein-MetS-Gruppe. Beim 6‑Monats-Follow-up wurden die linksventrikuläre Ejektionsfraktion (LVEF) und die Serumwerte für NT-proBNP („N-terminal pro-brain natriuretic peptide“) ermittelt sowie der prädiktive Wert von MetS mit Mikroalbuminurie für die Erholung der Herzfunktion mittels multivariabler logistischer Regressionsmodellierung bestimmt.. In die Studie wurden 530-STEMI-Patienten eingeschlossen (Durchschnittsalter: 66,6 Jahre). Die Analyse der Kovarianz zeigte, dass die Erholung der LVEF in der Normalbuminurie/kein-MetS-Gruppe besser war als in den Gruppen mit Normalbuminurie/MetS, Mikroalbuminurie/kein MetS und Mikroalbuminurie/MetS (49,22 vs. 48,92 vs. 47,48 vs. 46,99 %; p < 0,001), wenn die LVEF in der akuten Phase die Kovariable war. Der NT-proBNP-Wert der Normalbuminurie/kein-MetS-Gruppe beim 6‑Monats-Follow-up war niedriger als der in der Gruppe mit Mikroalbuminurie/MetS (p < 0,001). Die weitere Regressionsanalyse ergab, dass eine geringere Wahrscheinlichkeit für eine vollständige Erholung der Herzfunktion nach 6 Monaten bei Patienten mit Mikroalbuminurie bestand (Odds Ratio: 0,455) als bei Patienten ohne Mikroalbuminurie (95 %-Konfidenzintervall, 95 %-KI: 0,316–0,655; p < 0,001).. Auch wenn sich die Herzfunktion nach AMI bei Patienten mit MetS und Mikroalbuminurie nach Revaskularisierung wieder verbessern kann, ist diese Verbesserung nicht so gut wie die bei Patienten ohne Mikroalbuminurie, was ein Hinweis darauf ist, dass dieser Untergruppe besondere klinische Aufmerksamkeit gewidmet werden sollte.

Topics: Aged; Biomarkers; Humans; Metabolic Syndrome; Myocardial Infarction; Natriuretic Peptide, Brain; Peptide Fragments; ST Elevation Myocardial Infarction; Stroke Volume; Ventricular Function, Left

The presence of metabolic syndrome (MS) significantly increases the risk of developing cardiovascular diseases that lead to chronic heart failure (CHF). The values of NT-proBNP, ST-2, and CRP markers and their mutual correlations were studied in 37 patients with chronic heart failure (CHF) without metabolic syndrome (MS) (group 1) and 37 patients with CHF with MS (group 2). The aim of the study was to determine the features of their changes in patients with CHF complicated by MS, and to rank patients by assigning a rank value to the values of NTproBNP, ST2, and CRP concentrations. The average ST2 level was 51±24 ng/ml in group 1 and 62±27 ng/ml in group 2. The average values of CRP in group 1 were 23.1±5.3 mg/l, in group 2-33.0±4.4 mg/l (p<0.05). The NTproBNP level was 2413±1586 PG/ml and 2721±1635 PG/ml in groups 1 and 2, respectively. Correlations between the values of NTproBNP and ST2, NTproBNP and CRP were demonstrated. In the group of CHF with MS, compared with the group of CHF, there were significantly more patients with the most pronounced pathological levels of damage markers: the number of patients with a General rank of 6-9 in the group of CHF with MS was 59%, in the group of CHF without MS-38% (p<0.05). Of the 18 patients who died, 17 were among those who had an overall rank of 6 to 9, only 1 patient who died after hospitalization had an overall rank of 5. At the same time, among 22 patients who had improved CHF in the outcome of hospitalization, 18 patients had a total rank from 0 to 5, and in 4 patients of this category, the clinical manifestations of CHF remained virtually unchanged. The results of ranking the level of the studied laboratory markers indicate that they can be used as a predictor of various outcomes of CHF.

Topics: Biomarkers; Chronic Disease; Heart Failure; Humans; Laboratories; Metabolic Syndrome; Natriuretic Peptide, Brain; Peptide Fragments; Prognosis

In community studies, plasma B-type natriuretic peptide (BNP) is positively associated with cardiovascular disorders. Those born with very low birth weight (VLBW) have increased risk of metabolic and vascular disorders in later life, but plasma concentrations of natriuretic peptides have not been studied. The objectives here were to evaluate BNP and C-type natriuretic peptide (CNP)-a putative marker of vascular risk-in young adults born with VLBW.. In all, 220 VLBW cases and 97 matched controls were studied 28 years after birth during a 2-day period at 1 research center. Aminoterminal (NT) products (NTproBNP, NTproCNP) and a range of conventional vascular risk factors including echocardiographic indices were measured along with genetic polymorphisms known to increase plasma NTproBNP.. VLBW individuals were smaller, had smaller hearts, reduced stroke volume and endothelial function, and higher systolic blood pressure and arterial elastance. Of the many humoral vascular and metabolic risk factors measured, including NTproBNP, only plasma NTproCNP (higher in VLBW individuals) differed significantly. Across all individuals, associations of NTproCNP with each of 7 conventional risk factors, as well as with arterial elastance, were positive, whereas associations of NTproBNP with risk were all inverse. In multivariate analysis, the genetic variant rs198358 was independently associated with NTproBNP.. In young adults at increased risk of cardiovascular disease, higher NTproCNP likely reflects a compensatory vascular response to vascular stress, whereas the negative link with NTproBNP likely reflects beneficial genetic mutations. The ratio of NTproBNP to NTproCNP may provide a novel index of ideal cardiovascular health.

Topics: Adult; Biomarkers; Case-Control Studies; Echocardiography; Female; Humans; Infant, Newborn; Infant, Very Low Birth Weight; Male; Metabolic Syndrome; Natriuretic Peptide, Brain; Natriuretic Peptide, C-Type; Prospective Studies; Risk Factors; Signal Transduction

Natriuretic peptide type B (BNP) is a marker of myocardium injury. This peptide has been associated with metabolic risk markers, although controversy exists in this regard. The aim of the present study was to determine the correlation of plasma BNP levels with metabolic risk parameters.. A retrospective, observational study that included 152 patients, who were classified according to their clinical diagnosis as patients with metabolic syndrome. Plasma BNP levels and clinical metabolic parameters were assessed by using Spearmańs rank correlation coefficient.. A significant inverse association with weight (r=-.408; p<.0001) and BMI (r=-.443; p<.001) was obtained. While a positive significant association with systolic pressure (r=.324; p<.001) was observed. A significant decrease was found in BNP levels and components of metabolic syndrome. (p<.05).. Based on the results from this study, we can conclude that BNP determination could be an adequate metabolic marker.

Topics: Biomarkers; Blood Pressure; Body Weight; Cross-Sectional Studies; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Retrospective Studies; Statistics, Nonparametric

Topics: Air Pollutants; Biomarkers; Cardiac Rehabilitation; Cardiovascular Diseases; Comorbidity; Humans; Hypolipidemic Agents; Metabolic Syndrome; Natriuretic Peptide, Brain; Peptide Fragments; Percutaneous Coronary Intervention; Predictive Value of Tests; Risk Factors; Transcatheter Aortic Valve Replacement; Treatment Outcome

Low levels of natriuretic peptide may activate the renin-angiotensin-aldosterone system, which may contribute to the development of obesity. Therefore, in study we aim to evaluate the relationship between metabolic syndrome (MetS) and serum N-terminal pro‒B-type natriuretic peptide (NT-proBNP) concentration in kidney transplant recipients.. Fasting blood samples were obtained from 66 kidney transplant recipients. MetS and its components were defined using the diagnostic criteria of the International Diabetes Federation.. A total of 20 patients (30.3%) had MetS. Hypertension, prevalence of diabetes, use of statin or fibrate, body weight, body mass index, waist circumference, body fat mass, and levels of systolic blood pressure, total cholesterol, triglyceride, blood urea nitrogen, insulin, and HOMA-IR were higher, whereas the levels of high-density lipoprotein cholesterol and NT-proBNP were lower in patients with MetS. Logarithmically transformed creatinine and log-HOMA-IR were associated with NT-proBNP levels in a multivariable linear regression analysis. Multivariate logistic regression analysis revealed that NT-proBNP was an independent predictor of MetS in kidney transplant recipients.. Our study has revealed that fasting level of NT-proBNP was negatively associated with MetS and that serum creatinine and HOMA-IR were independent predictors of serum NT-proBNP level in kidney transplant recipients.

Topics: Adult; Aged; Body Mass Index; Creatinine; Female; Humans; Kidney Transplantation; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Prevalence; Waist Circumference

NTproBNP and BNP levels are reduced in obese subjects, but population-based data comparing the pattern of this relationship in the full spectrum of insulin-resistance mediated conditions, overweight/obesity, metabolic syndrome and diabetes, are limited.. The study-base were 3244 individuals aged 45-74 years, none of whom had heart failure, 1880 without diabetes and 1364 with diabetes, identified as part of two surveys of the population-based Casale Monferrato Study. All measurements were centralized. We examined with multiple linear regression and cubic regression splines the relationship between NTproBNP and BMI, independently of known risk factors and confounders. A logistic regression analysis was also performed to assess the effect of overweight/obesity (BMI ≥ 25 kg/m. NT-proBNP levels are lower in overweight/obesity, even in those with diabetes. Both insulin-resistance and chronic low-grade inflammation are involved in this relationship. Further intervention studies are required to clarify the potential role of drugs affecting the natriuretic peptides system on body weight and risk of diabetes.

Topics: Aged; Biomarkers; Cohort Studies; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Insulin Resistance; Italy; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Obesity; Overweight; Peptide Fragments; Population Surveillance

Metabolic syndrome (MetS) has been associated with left ventricular diastolic dysfunction (LVDD) with preserved systolic function. This study aims at identifying the predictive factors for LVDD in MetS patients.. The studied group comprised 72 consecutive hospitalized patients (2010-2011) diagnosed with MetS based on AHA/NHLBI/IDF 2009 definition, free of cardiovascular disease (36.11% males, age 59.19 ± 5.26 years), who underwent echocardiographic examination. Laboratory measurements of high-sensitivity C-reactive protein (hs-CRP), fibrinogen (Fbg) and interleukin-6 (IL-6), 8-isoprostaglandin-F2alpa (8-isoPGF2α), uric acid, glutathione peroxidases, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured.. LVDD was identified in 47 (65.27%) of the MetS patients. The diastolic blood pressure (DBP) was the strongest prediction factor for LVDD (areas under the receiver operating curve [AUC]: 0.73, odds ratios [OR]: 1.065). The number of MetS criteria was also significantly predictive for LVDD (AUC: 0.65, OR: 2.029, P < 0.04). IL-6, hs-CRP, Fbg, and NT-proBNP were predictive for LVDD when receiver operating curve (ROC) analyses were used. The multimarker model comprising age, sex, SBP and DBP, waist, circumference, triglycerides along with hs-CRP, IL-6, and NT-proBNP had the best predictive capacity (AUC: 0.88, P = 0.0001). In multivariate analysis, IL-6 remained an independent predictive biomarker for LVDD (OR: 2.045).. Both MetS components and biomarkers of inflammation (IF) are predictive factors for LVDD. The best predictive multimarker model for LVDD in MetS patients is composed of waist, triglycerides (TGL), SBP, DBP, fasting glucose, IL-6, hs-CRP, and NT-proBNP. IL-6 remains an independent predictive biomarker for LVDD in MetS patients, underlining the importance of IF in the evolution of MetS to subclinical cardiac damage.

Topics: Adult; Age Factors; Aged; Biomarkers; Blood Pressure; Echocardiography; Female; Hospitalization; Humans; Interleukin-6; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; ROC Curve; Sensitivity and Specificity; Sex Factors; Ventricular Dysfunction, Left; Waist Circumference

In whites, the minor G allele of the atrial natriuretic peptide (ANP) genetic variant rs5068 is associated with higher circulating levels of ANP and B-type natriuretic peptide (BNP), lower risk of hypertension, higher high-density lipoprotein (HDL) cholesterol plasma levels, and lower prevalence of obesity and metabolic syndrome. The observed phenotype is consistent with the blood pressure lowering and metabolic properties of ANP and BNP. The cardiovascular and metabolic phenotype associated with rs5068 genotypes in African Americans is undefined. We genotyped 1631 African Americans in the Multi-Ethnic Study of Atherosclerosis (MESA) for rs5068 and investigated their phenotype. Genotype frequencies of rs5068 were 93.2% AA (n = 1520), 6.7% AG (n = 110) and 0.1% GG (n = 1). All subsequent analyses are AG + GG versus AA genotype. Using a Bonferroni corrected level of significance of 0.005, the prevalence of metabolic syndrome (23% vs 38%, age-sex-adjusted p = 0.002) and triglycerides plasma values (76 vs 90 mg/dl, age-sex-BMI adjusted p = 0.004) were both significantly lower in the AG+GG genotypes. In the AG+GG genotypes, the prevalence of diabetes (8% vs 18%, age-sex-BMI-adjusted p = 0.02) and insulin plasma levels tended to be lower (4.8 vs 5.7 μU/ml, age-sex-BMI adjusted p = 0.04) whereas HDL-cholesterol levels tended to be higher (55 vs 50 mg/dl, age-sex-BMI-adjusted p = 0.04). No association was found with hypertension. The association between the rs5068 G allele and a favorable metabolic phenotype is now shown in African Americans. The rs5068 AG+GG genotypes are associated with lower prevalence of metabolic syndrome and lower triglycerides values.

Topics: Aged; Aged, 80 and over; Alleles; Atherosclerosis; Atrial Natriuretic Factor; Black or African American; Cardiovascular Diseases; Cardiovascular System; Cholesterol, HDL; Cohort Studies; Ethnicity; Female; Genotype; Geography; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Obesity; Phenotype; Prevalence; Triglycerides; United States

Our aim was to investigate whether the presence of metabolic syndrome (MetS) and diabetes mellitus (DM) influenced the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and its prognostic performance in coronary artery disease (CAD).. The present study enrolled a total of 1638 CAD patients. Multivariate regression analyses were carried out to relate NT-proBNP to metabolic components, nondiabetic MetS, DM, and MetS score. Furthermore, we examined the prognostic performance of NT-proBNP in patients with non-MetS, nondiabetic MetS, and DM.. NT-proBNP levels correlated inversely with BMI (β=-0.11, P=0.003) and correlated positively with fasting glucose (β=0.12, P=0.001). There were no significant relationships of NT-proBNP with other metabolic parameters. Compared with non-MetS, the presence of DM significantly increased NT-proBNP levels (P=0.004), whereas nondiabetic MetS did not influence NT-proBNP levels (P=0.954). During the median follow-up of 21 months, 109 all-cause deaths occurred. NT-proBNP levels independently predicted all-cause deaths irrespective of the presence of nondiabetic MetS and DM (Pinteraction=0.43).. DM, but not nondiabetic MetS, is associated with higher NT-proBNP levels. NT-proBNP can still predict death in patients with CAD, even with the confounding effect of MetS and diabetes.

Topics: Aged; Biomarkers; Blood Glucose; Chi-Square Distribution; China; Coronary Angiography; Coronary Artery Disease; Databases, Factual; Diabetes Mellitus; Female; Humans; Kaplan-Meier Estimate; Linear Models; Male; Metabolic Syndrome; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Factors; Up-Regulation

Revealed elevated Nt-pro-BNP concentration in 11% of healthy people aged 19-24 years and 22% of middle-aged (34-55 years); in the case of the metabolic syndrome increasing Nt-pro-BNP concentration in blood is set to 90%. Elevated levels of Nt-pro-BNP in peripheral blood occurs with increasing age; set higher peptide concentration in women. Inhibition of lymphoproliferation and differentiation of lymphocytes with increasing content of Nt-pro-BNP in blood is associated with deficiency of IL-2 content due to increased concentration and IL-10. Immunosuppressive effect of IL-10 appears more at innate immune reactions decrease blood levels of naive T-lymphocytes CD45RA+, natural killer cells, T cell adhesion receptor (CD56+) and adhesion receptor ligand (CD62L+). To prevent loss of cell-cell pool, the effect is activated Nt-pro-BNP. No statistically significant correlation between increased Nt-pro-BNP concentration in blood and the content of serum IgM, IgG, IgA, IgE, IL-6, TNF-α, IFN-γ, CEC Clq and C3d, as well as glucose, hemoglobin, transferrin, iron and free fatty acids in healthy people.

Topics: Adult; Biomarkers; Cytokines; Histocompatibility Antigens Class II; Humans; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Young Adult

To estimate cardiac chamber sizes and epicardial fat (EF) thickness in patients with chronic heart failure (CHF) and metabolic syndrome (MS).. The investigation enrolled 77 patients with CHF. The diagnosis of the latter was made on the basis of clinical symptoms and verified measuring N-terminal pro-brain natriuretic peptide levels in all the patients. A study group (SG) included 39 patients with CHF and MS. A control group comprised 38 CHF patients without MS. Clinical and biochemical blood tests and electrocardiography were performed in all the patients. Cardiac chamber sizes, myocardial wall thickness, and EF were estimated from echocardiographic findings. Fatty liver index (FLI) and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) were calculated in all the patients.. All the patients had clinical signs and symptoms of CHF. There were 25 (32%) men among the 77 patients. The mean age was 63.9±10.3 years. The patients with CHF and MS showed pronounced myocardial remodeling, which was manifested as significantly higher increases in the sizes of cardiac chambers and in the thickness of their walls and as larger EF thickness (EFT) and larger myocardial mass. In SG, EFT was 3.39±1.82 mm (p=0.00001). This group exhibited correlations between EFT and FLI (r=0.52; p=0.004), glycated hemoglobin levels (r=0.41; p=0.016), E peak (r=-0.25; p=0.005), E/A ratio (r=0.25; p=0.041), left ventricular (LV) end-systolic size (r=0.25; p=0.035), LV myocardial mass (r=0.29; p=0.038), NFS (r=0.29; p=0.002), and body mass index (r=0.29; p=0.003).. The found correlations between EFT and the clinical and metabolic parameters of CHD and cardiovascular diseases allow EFT to be regarded as a new marker of risk for MS and cardiovascular diseases.. Цель исследования. Оценка размеров камер сердца и толщины эпикардиального жира (ЭЖ) у пациентов с хронической сердечной недостаточностью (ХСН) и метаболическим синдромом (МС). Материалы и методы. В исследование вошли 77 больных с ХСН. У всех пациентов диагноз ХСН ставили на основании клинической картины и подтверждали измерением уровня N-концевого предшественника мозгового натрийуретического пептида. В основную группу (ОГ) включили 39 пациентов с ХСН и МС. В контрольную группу (КГ) вошли 38 пациентов с ХСН без МС. Всем больным проводили клинические и биохимические анализы крови, электрокардиографию. Оценивали размеры камер сердца, толщину стенок миокарда и ЭЖ по данным эхокардиографии. Всем больным рассчитывали индекс стеатоза печени (FLI), индекс фиброза печени (NFS). Результаты. У всех пациентов имелись клинические признаки и симптомы ХСН. Из 77 больных 25 (32%) составили мужчины. Средний возраст достигал 63,9±10,3 года. У пациентов с ХСН и МС наблюдалось более выраженное ремоделирование миокарда, что выражалось в достоверно большем увеличении размеров камер сердца и толщины их стенок, большей толщине эпикардиального жира (ТЭЖ), большей массе миокарда. ТЭЖ в ОГ составила 3,39±1,82 мм (p=0,00001). В ОГ получены корреляции между ТЭЖ и FLI (r=0,52; p=0,004), уровнем гликированного гемоглобина (r=0,41; p=0,016), пиком Е (r=–0,25; p=0,005), отношением Е/А (r=0,25; p=0,041), конечным систолическим размером (r=0,25; p=0,035), массой миокарда ЛЖ (r=0,29; p=0,038), NFS (r=0,29; p=0,002), индекса массы тела (r=0,29; p=0,003). Заключение. Полученные корреляции между ТЭЖ и клинико-метаболическими параметрами течения ХСН и МС обусловливают возможность рассмотрения ТЭЖ как нового маркера риска развития МС и сердечно-сосудистых заболеваний.

Topics: Adipose Tissue; Adult; Aged; Body Mass Index; Echocardiography; Exercise Test; Female; Heart Failure; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Pericardium; Statistics as Topic; Vascular Remodeling; Ventricular Remodeling

The natriuretic peptides, brain natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP), are cardiac-derived hormones and can serve as biomarkers for ventricular dysfunction. BNP has cardio-protective effects and is known as a regulator of metabolism. In the present study, to evaluate the relationship between natriuretic peptides and metabolic disorders, we focused on the association between NT-proBNP and metabolic syndrome-related molecule adiponectin (APN).. Forty-five apparently healthy men who underwent health examination at the Osaka University Health Care Center were enrolled for this study. Physical and biochemical parameters including serum APN and NT-proBNP concentrations were obtained from all the subjects.. The serum concentrations of NT-proBNP negatively correlated with metabolic disorder parameters, body mass index (BMI), waist circumferences, and fasting plasma glucose levels, but positively correlated with APN, suggesting that similar to APN, NT-proBNP is associated with metabolic disorders. Furthermore, increased serum concentrations of APN were found to be accompanied by increased serum concentrations of NT-proBNP and decreased BMI and mean intima-media thickness.. The serum concentrations of NT-proBNP are associated with APN concentrations and metabolic disorder parameters in healthy subjects.

Topics: Adiponectin; Adult; Asian People; Body Mass Index; Healthy Volunteers; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Tunica Intima; Tunica Media

Both metabolic syndrome (MetS) and N-amino terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) confer increased risk of cardiovascular diseases (CVD). We assessed if NT-proBNP levels were greater in people with uncomplicated MetS, who had neither CVD/chronic kidney disease (CKD) nor diabetes, as compared with subjects who met none of the defining criteria of the MetS.. A case-cohort study from the non-diabetic population-based Casale Monferrato study was performed, after exclusion of all subjects with established CVD, CKD [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2)], and CRP values ≥3 mg/L. Cases (n = 161) with MetS were compared with all subjects within the cohort (n = 124) who were completely free of any component of the MetS. Serum NT-proBNP was centrally measured by immunoenzymatic assay.. NT-proBNP levels were significantly higher in cases than in control subjects [35.4 (15.5-98.2) vs 24.4 (11.7-49.6) pg/mL, p = 0.014]. In logistic regression analysis, compared with NT-proBNP values in the lower quartiles (≤49.64 pg/mL), higher values conferred odds ratio 4.17 (1.30-13.44) of having the MetS, independently of age, sex, microalbuminuria, CRP, eGFR, and central obesity. This association was evident even after the exclusion of hypertensive subjects. Further adjustment for log-HOMA and diastolic blood pressure did not modify the strength of the association, while central obesity was a negative confounder.. Compared with people without any component of the MetS, those with uncomplicated MetS, who had neither CVD/CKD nor diabetes, had increased NT-proBNP values, even if they were normotensive and although absolute values were still in the low range. The insulin resistance state did not mediate this association, while central obesity was a negative confounder.

Topics: Aged; Body Mass Index; Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Dyslipidemias; Female; Humans; Hypertension; Insulin Resistance; Italy; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Obesity, Abdominal; Overweight; Peptide Fragments; Prediabetic State; Prevalence; Severity of Illness Index; Up-Regulation; Waist Circumference

It is now known that BNP and NT-proBNP levels are decreasing with increased BMI, regardless of other metabolic syndrome (MS) constituents. Additionally, testosterone deficiency may intensify frequency of ventricular rhythm disorders in obese individuals by inhibition of the parasympathetic system. Determination of heart rhythm turbulence (HRT) is a useful, noninvasive method used for evaluation of equilibrium of the vegetative system. The aim of the study was to evaluate effect of testosterone therapy on HRT and NT-proBNP levels in MS patients. Eighty males were qualified for the study. They were divided into 3 groups: I (n=30), males with testosterone deficiency syndrome and metabolic syndrome (MS+TDS+); II (n=25), males with MS+TDS-; III (n=25), healthy males. The patients with MS+TDS+ received Omnadrem 250 in the form of intramuscular injections for 9 weeks. Laboratory tests and 24-h Holter ECG were taken twice before the therapy and directly after completion of the therapy. Males with MS+TDS+ more often presented irregular HRT parameters and were characterised by lower NT-proBNP levels compared to the healthy individuals. Testosterone replacement therapy caused improvement of HRT and had no significant effect on the NT-proBNP level. Testosterone replacement therapy and body weight reduction may significantly decrease negative consequences of MS and TDS.

Topics: Arrhythmias, Cardiac; Body Mass Index; Hormone Replacement Therapy; Humans; Injections, Intramuscular; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Testosterone; Weight Loss

It has been shown that metabolic syndrome is associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. However, there is no study about the association between Nt-proBNP and metabolic syndrome in hypertensive patients.. : To elucidate the relationship between Nt-proBNP and components of metabolic syndrome in hypertensive patients.. Fasting blood samples were obtained from 74 hypertensive patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.. Forty-four hypertensive patients met the criteria for metabolic syndrome. We found that plasma Nt-proBNP levels were lower in hypertensive patients with metabolic syndrome attributable to inverse relationships between Nt-proBNP and albumin, triglyceride, insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and pancreatic β-cell function (HOMA-β). We further performed a multivariable linear regression analysis. The result showed that HOMA-IR is the independent predictor of plasma Nt-proBNP levels in hypertensive patients.. Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in hypertensive patients. HOMA-IR is the independent predictor of Nt-proBNP in hypertensive patients.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Cross-Sectional Studies; Female; Homeostasis; Humans; Hypertension; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Protein Precursors

To explore the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and metabolic syndrome (MS).. A total of 1323 Beijing residents (559 male) were investigated. MS was defined by the modified 2004 Chinese Diabetes Society criteria and 439 cases were diagnosed as MS according to this criteria. Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS. Multiple linear regression analysis was performed to analyze the association between NT-proBNP and characteristic variables.. NT-proBNP was significantly lower in MS group compared to non-MS group [32.51 (29.17, 36.14) ng/L vs.38.55 (35.73, 41.50) ng/L, P = 0.012] after adjusted for age and gender. NT-proBNP level decreased with the presence of MS components (from 0 to 4 or 5) (45.92, 37.24, 35.40, 31.55 and 33.65 ng/L respectively, P = 0.043 for linear trend). Among the components, groups with larger waist circumference, higher fasting glucose and triglycerides were associated with lower NT-proBNP level. After adjustment for potential confounders, compared with the lowest NT-proBNP quartile, the adjusted odds ratio of the second, third and fourth quartile for having MS were 0.782 (95%CI: 0.544 - 1.122, P > 0.05), 0.709 (95%CI: 0.489 - 1.028, P > 0.05), 0.604 (95%CI: 0.405 - 0.900, P < 0.05), respectively. Multiple linear regression analysis showed that female gender (β = 0.248, P < 0.001), age (β = 0.167, P < 0.001), systolic blood pressure (β = 0.154, P < 0.001) were positively related to NT-proBNP level while waist circumference (β = -0.082, P = 0.004), diastolic blood pressure (β = -0.085, P = 0.015), triglycerides (β = -0.101, P < 0.001), total cholesterol (β = -0.078, P = 0.004), eGFR (β = -0.150, P < 0.001) were negatively correlated to NT-proBNP level.. In this cohort, higher serum NT-proBNP concentration is associated with lower incidence of metabolic syndrome.

Topics: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Male; Metabolic Syndrome; Natriuretic Peptide, Brain; Peptide Fragments

Several pathomechanisms are implicated in the pathogenesis of metabolic syndrome (MetS), most of which have not been investigated in African Americans (AAs). We examined the contribution of a selected panel of biomarkers to the development of MetS in Jackson Heart Study (JHS) participants in this investigation.. We evaluated 3,019 JHS participants (mean age, 54 years; 64% women) with measurements for seven biomarkers representing inflammation (high-sensitivity C-reactive protein [CRP]), adiposity (leptin), natriuretic pathway (B-natriuretic peptide [BNP]), adrenal pathway (cortisol and aldosterone), and endothelial function (endothelin and homocysteine). We related the biomarker panel to the development of MetS on follow-up and to longitudinal changes in MetS components.. There were 278 (22.9%) of 1,215 participants without MetS at baseline who had development of new-onset MetS at follow-up. The incidence of MetS was significantly associated with serum aldosterone (P=0.004), CRP (P=0.03), and BNP (P for trend=0.005). The multivariable-adjusted odds ratios (95% CI) per SD increment of log biomarker were as follows: 1.25 (1.07-1.45) for aldosterone, 1.20 (1.02-1.43) for CRP, and 1.54 (1.07-2.23) and 1.91 (1.31-2.80) for low and high BNP quartiles, respectively. Aldosterone was positively associated with change in all MetS risk components, except low HDL cholesterol and waist circumference. CRP concentration was significantly and directly associated with change in systolic blood pressure (SBP) and waist circumference but inversely associated with HDL cholesterol. For BNP, we observed a U-shape relation with SBP and triglycerides.. Our analysis confirms that, in AAs, higher circulating aldosterone and CRP concentrations predict incident MetS. The nonlinear U-shape relation of BNP with MetS and its components has not been reported before and thus warrants replication.

Topics: Adult; Aged; Aldosterone; C-Reactive Protein; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain

Presence of left ventricular (LV) hypertrophy significantly increases cardiovascular risk in patients suffering from hypertension. Diagnostics of LV hypertrophy in hypertensive patients is not easy and there is still no method of enabling a simple and sufficiently sensitive dia-gnosis across a large patient population. The golden standard in LV hypertrophy diagnostics is echocardiography, and there are adverse opinions regarding the use of natriuretic peptides BNP and NT proBNP (NP) to diagnose LV hypertrophy.. We examined through echocardiography 173 hypertensive patients with signs of metabolic syndrome and a moderate increase in blood pressure (130- 159/ 85- 99 mm Hg) with an average age of 54.8 ± 13.54 years, i.e. 119 men and 54 women, who were divided into 2 groups; 1 with BMI > 30 (group A with a severe obesity) and the other without obesity, BMI < 30 (group B). Both groups were examined for BNP and NT proBNP levels.. We found a positive correlation between NP and LVMi, both for BNP (r = 0.169; p = 0.033) and for NT proBNP (r = 0.240; p = 0.002). NT proBNP statistically significantly predicts the given LV hypertrophy LK in people with BMI < 30 but not in obese people (BMI > 30).. Obese patients suffer from a higher occurrence of left ventricular hypertrophy and paradoxically a lower NP value than patients with a metabolic syndrome (MS) who are not obese. Natriuretic peptides have a limited diagnostic value when assessing left ventricular hypertrophy. They are only of value in patients who are not obese and whose kidney function and systolic myocardial function have not been impaired.

Topics: Adult; Aged; Body Mass Index; Comorbidity; Female; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Referral and Consultation

Topics: Female; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Metabolic Syndrome; Natriuretic Peptide, Brain; Peptide Fragments

According to some studies, polycystic ovarian syndrome (PCOS) patients have an increased risk for diabetes mellitus and often show an adverse cardiovascular risk profile. NT-proBNP was shown to have a high predictive value regarding cardiovascular events, especially in those without overt cardiovascular disease. The aim of this study was to investigate the levels of NT-proBNP in 70 women with PCOS and/or obesity in relation to other classical cardiovascular risk factors. There was no statistical difference between NT-proBNP levels between obese, lean PCOS and obese PCOS patients; between patients with or without metabolic syndrome; or between patients with different cardiovascular risk, according to The Androgen Excess and PCOS Society consensus. NT-proBNP does not show significant correlation to age, weight, BMI, WHR, WSR, systolic or diastolic blood pressure and results from oral glucose tolerance test (OGTT), except for immunoreactive insulin (IRI) at 120 min. NT-proBNP correlates weakly with HDL, but not with other indices of lipid metabolism.

Topics: Adult; Body Mass Index; Female; Humans; Metabolic Syndrome; Natriuretic Peptide, Brain; Obesity; Peptide Fragments; Polycystic Ovary Syndrome; Young Adult

Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF).. Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.. Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients.. Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.

Topics: Adult; Aged; Aged, 80 and over; Blood Glucose; Fasting; Female; Heart Failure; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain; Peptide Fragments

Recently, the role of aldosterone in metabolic syndrome (MS) has aroused interest and several reports have suggested that aldosterone blockade could be beneficial in reducing blood pressure (BP).. To examine the add-on effects of eplerenone (EP) on BP in patients with MS, 54 hypertensive patients with MS and 44 without MS were recruited. Systolic and diastolic BPs in mmHg before the initiation of EP was 144/84 ± 13/12 (MS group) and 147/85 ± 12/14 (non-MS group). Before the start of EP, all patients in both groups were treated with at least one antihypertensive drug. BPs were checked on every visit (at least every 2 months) and serum chemistries were measured every 4 months. The levels of microalbuminuria and aminoterminal pro-brain natriuretic peptide (NT pro-BNP) were determined before the start of and at the end of the study. Patients were followed for 1 year. If adverse effects were reported by patients or found in laboratory studies, EP was withdrawn.. One month after the start of EP, BPs were decreased to 140/80 ± 12/12 mmHg (MS group) versus 142/82 ± 11/12 mmHg (non-MS group) and there was no difference between the two groups. Towards the end of the study, BPs of both groups gradually decreased. At the end of the study, BPs of both groups were 129/76 ± 15/13 mmHg (MS group) versus 133/78 ± 13/11 mmHg (non-MS group). There was a significant difference in reduction of systolic BP between the two groups (p < 0.05). Add-on EP significantly decreased the levels of urinary excretion of albumin in MS patients but not in non-MS patients (p < 0.05). There was a significant correlation between reduction of systolic BP and NT pro-BNP but not microalbuminuria in the MS group (p < 0.05). There were no serious adverse effects in both groups.. EP may have some beneficial effects in lowering BP in patients with reduction of microalbuminuria.

Topics: Aged; Albuminuria; Antihypertensive Agents; Blood Pressure; Eplerenone; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Mineralocorticoid Receptor Antagonists; Natriuretic Peptide, Brain; Peptide Fragments; Prospective Studies; Spironolactone

Insulin resistance (IR) is part of the metabolic syndrome (Mets) that develops after lifestyle changes and obesity. Although the association between Mets and myocardial injury is well known, the effect of IR on myocardial damage remains unclear.. We studied 2200 normal subjects who participated in a community-based health check in the town of Takahata in northern Japan. The presence of IR was assessed by homeostasis model assessment ratio, and the serum level of heart-type fatty acid binding protein (H-FABP) was measured as a maker of silent and ongoing myocardial damage. H-FABP levels were significantly higher in subjects with IR and Mets than in those without metabolic disorder regardless of gender. Multivariate logistic analysis showed that the presence of IR was independently associated with latent myocardial damage (odds ratio: 1.574, 95% confidence interval 1.1-2.3) similar to the presence of Mets.. In a screening of healthy subjects, IR and Mets were similarly related to higher H-FABP levels, suggesting that there may be an asymptomatic population in the early stages of metabolic disorder that is exposed to myocardial damage and might be susceptible to silent heart failure.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Biomarkers; Cardiomyopathies; Cross-Sectional Studies; Early Diagnosis; Fatty Acid Binding Protein 3; Fatty Acid-Binding Proteins; Female; Humans; Hypertension; Incidence; Insulin Resistance; Japan; Male; Mass Screening; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Sex Characteristics

This study evaluated the relationship between individual components in metabolic syndrome (MetS) and amino-terminal pro-brain natriuretic peptide (NT-proBNP).. A screening program for MetS in 2008 in Taiwan excluded subjects aged <30 years and pregnant women. Fasting glucose, insulin level, high-sensitivity C-reactive protein (hsCRP), and NT-proBNP were assessed. A propensity-score matching process was used to select subjects with and without MetS comparable in age, gender, body height, and serum creatinine levels. A multiple regression model was used to determine the association between individual components of MetS and NT-proBNP. Finally 270 subjects with MetS and another 270 matched subjects without MetS aged ≥30 years were included.. The subjects with MetS had higher uric acid and hsCRP, but not NT-proBNP. Multiple regression model showed that log (NT-proBNP) was positively associated with systolic blood pressure (β=0.002 per mmHg, p=0.013), but negatively associated with body mass index (β=-0.017 per kg/m(2), p=0.018), triglyceride (β=-0.00048 per mg/dL, p=0.020) and insulin level (β=-0.005 per mU/L, p=0.005). Log (NT-proBNP) was neutral to waist circumference, fasting glucose, high-density lipoprotein cholesterol, and diastolic blood pressure.. MetS was not associated with serum NT-proBNP concentrations due to the contradictory effects of each component.

Topics: Adult; Biomarkers; Blood Glucose; C-Reactive Protein; Case-Control Studies; Female; Humans; Insulin; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Regression Analysis; Taiwan

Metabolic syndrome (MS) was independently associated with increased risk of incident heart failure and coronary artery disease. In this study, we sought to identify whether there is an association between metabolic syndrome components and left ventricular diastolic functions and brain natriuretic peptide (BNP) levels.. This study is a cross-sectional, observational study. Two hundred consecutive patients with MS were selected to form the study population. Echocardiographic parameters and BNP were determined. Mann-Whitney U test and Kruskal-Wallis test were used to compare BNP levels in categorical variables. Spearman rank correlation analysis was used to investigate the correlation between BNP level and other numerical variables. Linear regression analysis was used to find the variables affecting the BNP level.. BNP level was higher in females than males [11.14 (0.12-87) vs 7.49 (0.01-99) pg/dl, p=0.04]. None of the MS parameters affects the BNP level in MS patients. MS criteria number that the patient had was not related to BNP level. Sixty seven percent of patients had left ventricular (LV) diastolic dysfunction. BNP was independent from LV diastolic function. Multiple linear regression analysis demonstrated that having diabetes mellitus increases BNP level by 7.73 unit (β=7.73, 95% CI - 2.321 - 13.149, p=0.006).. None of the MS parameters affects the BNP level in MS patients. Diastolic dysfunction existence did not affect the BNP level of MS patients. There is an association between diabetes mellitus and BNP, independent of left ventricle diastolic functions.

Topics: Blood Glucose; Blood Pressure; Body Composition; Cholesterol, HDL; Cross-Sectional Studies; Diastole; Echocardiography, Doppler; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Regression Analysis; Sex Factors; Triglycerides; Ventricular Dysfunction, Left

The aim of this study was to evaluate early cardiac abnormalities in obese children by the conventional echocardiography and to verify whether N-terminal pro B-type natriuretic peptide (NT-proBNP) differ between obese and healthy children.. We started this study with 68 obese children and 35 healthy controls matched for age and sex. Body mass index (BMI) was calculated. Children with a BMI > or = 95th percentile were considered obese. Thirty children in the obese group were also diagnosed with metabolic syndrome, according to the International Diabetes Federation criteria. Standard echocardiographic study was performed on each patient and control subject. Diastolic filling parameters were evaluated using pulsed-wave tissue Doppler method. Blood samples were taken at 8 a.m. to study blood biochemistry tests, including insulin, lipids, glucose, and NT-proBNP. Serum NT-proBNP levels were measured by a solid-phase, enzyme-labeled chemiluminescent immunometric assay. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Children with HOMA-IR > 3.16 were considered insulin-resistant.. There were diastolic filling abnormalities in obese children, as shown by a decreased mitral valve early filling (E) wave/late filling (A) ratio and a prolongation in E-wave deceleration time. The levels of NT-proBNP were not statistically different among the groups. The levels of NT-proBNP were not different between obese children with and without metabolic syndrome, those with and without hypertension, and those with and without insulin resistance, respectively.. Although there were diastolic filling abnormalities in obese children, their NT-proBNP levels were not different from healthy controls. It seems that there is no diagnostic value in NT-proBNP levels between obese children and healthy controls.

Topics: Adolescent; Biomarkers; Body Mass Index; Child; Diastole; Echocardiography; Female; Heart Diseases; Humans; Hypertension; Insulin Resistance; Male; Metabolic Syndrome; Natriuretic Peptide, Brain; Obesity; Peptide Fragments; Prevalence; Prospective Studies; Risk Factors

A low serum adiponectin level is associated with a high incidence of coronary artery disease (CAD) in the healthy population. Paradoxically, serum adiponectin is elevated in patients with severe CAD or chronic heart failure. We investigated the determinants of serum high molecular weight (HMW) adiponectin in patients with CAD.. We studied 228 consecutive patients with CAD confirmed by angiography. Anemia was defined as a hemoglobin of <13.0 g/dL in men and<12.0 g/dL in women. A high plasma B-type natriuretic-peptide (BNP) was defined as >100 pg/mL. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min for more than 3 months. The patients with CAD were divided into eight groups according to the presence or absence of anemia, high BNP, and/or CKD.. In all 228 patients with CAD, serum HMW adiponectin correlated positively with age, high-density-lipoprotein cholesterol (HDL-C), and BNP, while this parameter showed negative correlations with body mass index, insulin resistance, triglycerides, eGFR, and hemoglobin. Multivariate analysis showed that HDL-C, BNP, gender, and age were independently associated with the HMW adiponectin. Serum HMW adiponectin was lower in CAD patients with than without metabolic syndrome. Serum HMW adiponectin and the HMW/total adiponectin ratio were highest in CAD patients who had anemia, high BNP, and CKD among the groups.. In patients with CAD, metabolic syndrome is associated with a lower serum HMW adiponectin, while the presence of anemia, high BNP, and CKD is associated with elevation of the serum HMW adiponectin.

Topics: Adiponectin; Aged; Anemia; Biomarkers; Cardio-Renal Syndrome; Coronary Artery Disease; Female; Humans; Logistic Models; Male; Metabolic Syndrome; Middle Aged; Molecular Weight; Natriuretic Peptide, Brain; Syndrome

Urotensin II (UII) exerts multiple effects on the cardiovascular system, acts as a diabetogenic agent, and may also contribute to the development of the metabolic syndrome (MetS). The aim of this study was to determine circulating UII in patients with type 2 diabetes mellitus (T2DM) and its relationship with MetS. A total of 360 consecutive patients with T2DM were included. MetS presence/absence (MetS [+]/[-]) was defined according to American Heart Association/National Heart, Lung and Blood Institute criteria. Plasma concentrations of UII were determined by radioimmunoassay. UII levels were significantly higher in MetS (+) than in MetS (-) T2DM patients (0.97 pg/mL [0.93-1.01], n=294 vs 0.82 pg/mL [0.75-0.88] pg/mL, n=66, respectively; P<.001). Multiple logistic regression analysis showed that UII was significantly associated with MetS (+) (odds ratio, 6.41 [95% confidence interval, 1.21-16.04]; P=.02). UII plasma concentrations are significantly higher in T2DM patients presenting with MetS. Therefore, circulating UII may participate in the worsening course of some T2DM patients and may provide novel therapeutic perspectives.

Topics: Aged; Atrial Natriuretic Factor; Biomarkers; Diabetes Mellitus, Type 2; Female; Humans; Logistic Models; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Phenotype; Protein Precursors; Retrospective Studies; Urotensins

Angiotensin receptor blockers (ARBs) are known to reduce the cardiovascular risk in hypertensive patients. This study was designed to examine the effect of an ARB candesartan on subclinical atherosclerosis assessed by cardio-ankle vascular index (CAVI) in comparison with calcium channel blockers (CCBs) alone in hypertensive patients with metabolic syndrome (MetS). A total of 53 consecutive hypertensive patients with MetS were randomly assigned to the candesartan group, in which candesartan was added on, or the CCBs group, in which CCBs were added on. Clinical and biological parameters were obtained before and after the 12-month treatment period. The primary measure of efficacy was the %change in CAVI. When treated with candesartan, but not CCBs, CAVI significantly decreased from 8.7 to 7.7 by 11%. Blood pressure (BP) significantly decreased with both treatments, but the differences between groups were not significant. The changes in other parameters remained unchanged in both the groups. Analysis of covariance found that both the BP reduction and the therapy difference contributed to the decrease in CAVI, but the BP reduction was not involved in the decrease in CAVI caused by the difference in the therapy. Candesartan may be a better antihypertensive drug than CCBs to improve subclinical atherosclerosis of patients with MetS.

Topics: Ankle; Antihypertensive Agents; Arteries; Benzimidazoles; Biphenyl Compounds; Blood Pressure; Carotid Arteries; Female; Humans; Hypertension; Kidney; Male; Metabolic Syndrome; Middle Aged; Monitoring, Ambulatory; Natriuretic Peptide, Brain; Tetrazoles; Ultrasonography

The common C34T polymorphism in the AMP deaminase-1 (AMPD1) gene results in an inactive enzyme in homozygotes for the mutated T allele. Some studies have shown an association of T allele with longer survival in heart failure (HF) and/or coronary artery disease (CAD). The aim of this study was to assess genotype-phenotype correlations in such patients, with emphasis on components of the metabolic syndrome.. Ninety-seven patients with CAD without HF (CAD+ HF-) and 104 with HF (HF+) were genotyped by PCR-RFLP. The genetic control group comprised 200 newborns.. No significant differences were found in the frequency of AMPD1 genotypes between the groups. In the CAD+ HF- group, the carriers of T allele compared to CC homozygotes had significantly lower values of waist circumference (89.5+/-8.5 versus 97.7+/-11.2 cm; p = 0.00029), waist/hip ratio (p = 0.0059) and BMI (p = 0.045). There was no diabetes or fasting glycaemia > or =126 mg/dL in T carriers, while these features were present in 25% of CC homozygotes (p = 0.0024). In the HF+ group, a tendency towards a lower prevalence of diabetes (20 % versus 41%; p = 0.068) and significantly lower systolic blood pressure (p = 0.048) were observed in T allele carriers.. C34T AMPD1 polymorphism may be associated with reduced frequency of obesity in CAD patients and of hyperglycaemia and diabetes in both CAD and HF patients. Morphometric parameters associated with adipose tissue distribution and parameters of glucose metabolism should be analysed as potential confounders in further studies on the role of polymorphisms of AMPD1 and other genes associated with AMP and adenosine metabolism in cardiovascular disease.

Topics: AMP Deaminase; Case-Control Studies; Coronary Artery Disease; Female; Genetic Predisposition to Disease; Heart Failure; Humans; Kidney Function Tests; Male; Metabolic Syndrome; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain; Polymorphism, Single Nucleotide; Regression Analysis; Ultrasonography; Waist Circumference

The roles of metabolic syndrome and chronic subclinical inflammation in arterial stiffening and the development of heart failure remain to be elucidated. Whether adiponectin and high-sensitivity C-reactive protein (hs-CRP) were independently related to brachial-ankle pulse-wave velocity (ba-PWV) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in the general population were investigated. Eligible study subjects were 445 Chinese residents aged > or =40 years who participated in a community-based survey, underwent examination of ba-PWV, and had complete data of serum adiponectin, hs-CRP (<10 mg/L), and NT-pro-BNP. Adiponectin, but not hs-CRP, was independently related to ba-PWV (standardized regression parameter -0.107, p <0.05) when age, gender, body mass index, and number of metabolic syndrome components were accounted for. On the other hand, ba-PWV, adiponectin, and hs-CRP were independently related to NT-pro-BNP (standardized regression parameters 0.116, 0.188, and 0.094, respectively; all p <0.05) when age, gender, body mass index, number of metabolic syndrome components, and renal function were accounted for. In conclusion, adiponectin, but not hs-CRP, is independently associated with both ba-PWV and NT-pro-BNP in the general population. Because adiponectin, hs-CRP, ba-PWV, and NT-pro-BNP may represent markers for metabolic syndrome, chronic subclinical inflammation, arterial stiffness, and ventricular dysfunction, respectively, our results suggest that adiponectin may directly modulate both arterial stiffening and ventricular dysfunction. In contrast, hs-CRP may independently contribute to ventricular dysfunction, but not arterial stiffening.

Topics: Adiponectin; Adult; Aged; Aged, 80 and over; Anthropometry; Biomarkers; Blood Flow Velocity; C-Reactive Protein; Cardiovascular Diseases; China; Enzyme-Linked Immunosorbent Assay; Humans; Inflammation; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Pulse; Radioimmunoassay; Risk Assessment; Risk Factors; Surveys and Questionnaires

In this study we investigated N-terminal pro-brain natriuretic peptide (Nt-proBNP) levels in patients with metabolic syndrome (MetS) and its relationship between MetS components.. Thirty nine recently diagnosed MetS cases and 59 control cases were included in the present study. Left ventricular mass index (LVMI) was calculated and Nt-proBNP was determined.. Both groups were similar in terms of age and sex. Body mass index were significantly higher in MetS than non-MetS. LVMI measurements were not different between MetS and control groups (p=0.168). Nt-proBNP levels were similar in both groups (p=0.954). There was a significant correlation between Nt-proBNP and LVMI, age, serum LDL- and HDL-cholesterol levels. Nt-proBNP was independently related with age (beta=0.357, p=0.015) and LDL-cholesterol (beta=-0.255, p=0.049) in the multivariate analysis.. Nt-proBNP levels don't have a significant increase in MetS. But there was a significant relationship between Nt-proBNP levels and age and LDL-cholesterol.

Topics: Adolescent; Adult; Age Factors; Aged; Blood Pressure; Body Mass Index; Cholesterol, HDL; Cholesterol, LDL; Female; Heart Ventricles; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Ventricular Dysfunction, Left; Young Adult

Urate, a naturally-occurring antioxidant, is a marker/factor for cardiovascular disease. Hyperuricaemia is associated with IR, MetS and endothelial dysfunction. We characterised the associations between neurohormones, uricaemia, and glucose homeostasis in type 2 diabetes mellitus (T2DM) males. Cross-sectional; 705 T2DM males divided into two groups: uric acid < 7.0 mg/dl (normouricaemic; n=476) versus uric acid >or= 7.0 mg/dl (hyperuricaemic; n=229). HOMA beta-cell function (B), insulin sensitivity (S), hyperbolic product (BxS), and (BxS) loss rate were determined alongside neurohormones (Nt-proANP, BNP, Big ET-1 and UII). Mean age and diabetes duration were not different between groups. Hyperuricaemics had more macroangiopathy, total/central adiposity, IR, hypertension, dyslipidemia and MetS prevalence. Nt-proANP and BNP levels were more than twice as high in hyperuricaemics, whereas Big ET-1 and UII were higher by 46% and 14%, respectively. HOMA (BxS) was higher in hyperuricaemics: 31 (16)% vs. 26 (18)% (p=0.0004). BxS loss rate was faster in normouricaemics: 1.36 (0.54)% vs. 1.20 (0.43)%/year(-1) (p<0.0001 ). The proportion with HbA(1C) < 7.0% was 39% (normouricaemics) vs. 49% (hyperuricaemics; p=0.0091). In T2DM males, hyperuricaemia is associated with raised neurohormones together with better beta-cell indices. Urate's dual properties may translate into beneficial (glucose homeostasis) and detrimental (raised neurohormones) effects.

Topics: Aged; Atrial Natriuretic Factor; Biomarkers; Blood Glucose; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Endothelin-1; Glycated Hemoglobin; Humans; Hyperuricemia; Insulin; Insulin-Secreting Cells; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Up-Regulation; Uric Acid

Although the metabolic syndrome (MetS) is positively associated with high-sensitivity C-reactive protein (hsCRP), negatively associated with N-terminal pro-brain natriuretic peptide (Nt-proBNP) and inconsequently related to urine albumin/creatinine ratio (UACR) they are all associated with cardiovascular events. Therefore, we wanted to determine the influence of MetS on the predictive values of UACR, hsCRP and Nt-proBNP. On the basis of the definition of MetS by the International Diabetes Federation, a Danish population sample of 1983 apparently healthy subjects was divided into three groups: 530 subjects without any elements of MetS, 1093 subjects with some elements of MetS and 360 subjects with MetS. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (composite cardiovascular end point, CEP) occurred in 204 subjects. In Cox-regression analyses adjusting for age, gender and smoking, all three cardiovascular risk markers predicted CEP independently of MetS. Despite no significant interaction with MetS, high log(hsCRP) was associated with CEP primarily in subjects without any elements of MetS (hazard ratio (HR)=4.5 (1.5-14.0), P<0.01), log(Nt-proBNP) primarily in subjects with some elements of MetS (HR=3.0 (1.6-5.6), P<0.01), and logUACR independently of elements of MetS. Pre-specified gender-adjusted (men/women) cutoff values of hsCRP > or = 6.0/7.3 mg l(-1) predicted CEP in subjects without elements of MetS with positive and predictive values of 11.5 and 98%, respectively. UACR > or = 0.73/1.06 mg mmol(-1) predicted CEP in subjects with MetS with positive and predictive values of 23.5 and 93%, respectively. In apparently healthy subjects, high hsCRP was associated with CEP primarily in subjects without MetS, high Nt-proBNP in subjects with elements of MetS and UACR independently of MetS.

Topics: Adult; Aged; Albuminuria; Biomarkers; C-Reactive Protein; Cardiovascular Diseases; Creatinine; Female; Humans; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Regression Analysis; Risk Factors

Experimental studies suggest that the natriuretic peptides influence lipid and fatty acid metabolism. Although it has been shown that obese individuals have reduced natriuretic peptide levels, conflicting data exist on the relation of natriuretic peptide levels to other metabolic risk factors.. We examined the association of plasma levels of B-type natriuretic peptide and N-terminal pro-atrial natriuretic peptide with metabolic risk factors, the metabolic syndrome, and insulin resistance in 3333 Framingham study participants free of heart failure (mean age, 58 years; 54% women). Regression analyses were performed, with adjustment for clinical and echocardiographic variables. Plasma natriuretic peptide levels were inversely associated with all components of the metabolic syndrome except for elevated blood pressure. Adjusted natriuretic peptide levels were lower in persons with the metabolic syndrome compared with those without the metabolic syndrome: In men, B-type natriuretic peptide was 24% lower (P<0.001) and N-terminal pro-atrial natriuretic peptide was 16% lower (P<0.001); in women, B-type natriuretic peptide was 29% lower (P<0.001) and N-terminal pro-atrial natriuretic peptide was 18% lower (P<0.001). Individuals with insulin resistance, as indicated by an elevated homeostasis model assessment (HOMA-IR) index, had lower levels of B-type natriuretic peptide (P=0.009 in men, P<0.001 in women) and N-terminal pro-atrial natriuretic peptide (P<0.001 in men, P=0.001 in women).. Having several metabolic risk factors is associated with low circulating natriuretic peptide levels, even after adjustment for body mass index. These findings raise the possibility that reduced natriuretic peptide activity is a manifestation of the metabolic syndrome, which may have important clinical and pathophysiological implications.

Topics: Aged; Ambulatory Care; Atrial Natriuretic Factor; Biomarkers; Body Mass Index; Female; Heart Failure; Humans; Insulin; Insulin Resistance; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Obesity; Protein Precursors; Risk Factors; Ultrasonography

We wanted to investigate the relationship of N-terminal pro brain natriuretic peptide (Nt-proBNP) to metabolic and hemodynamic cardiovascular (CV) risk factors in the general population. From a population-based sample of 2656 people 41, 51, 61, or 71 years of age, we selected 2070 patients without previous stroke or myocardial infarction who did not receive any CV, antidiabetic, or lipid-lowering treatment in 1993 to 1994. Traditional CV risk factors, 24-hour blood pressures, left ventricular (LV) mass, and ejection fraction by echocardiography, pulse wave velocity, urine albumin/creatinine ratio (UACR), and serum Nt-proBNP were measured in 1993 to 1994. The metabolic syndrome was defined in accordance with the definition of the European Group for the Study of Insulin Resistance (EGIR). Higher log(Nt-proBNP) was in multiple regression analysis related to female gender (beta=-0.37), older age (beta=0.32), higher clinic pulse pressure (beta=0.20), lower serum total cholesterol (beta=-0.15), lower LVEF (beta=-0.08, all P<0.001), lower log(serum insulin) (beta=-0.07), lower log(plasma glucose) (beta=-0.06, both P<0.01, lower log(serum triglyceride) (beta=-0.06), lower body mass index (beta=-0.05); lower heart rate (beta=-0.05), higher logUACR (beta=0.04, all P<0.05) and higher log(LV mass index) (beta=0.04, P=0.07), adjusted R2=0.35, P<0.001). The metabolic syndrome was associated with lower Nt-proBNP (35 pg/mL versus 48 pg/mL; P<0.001) and shifted the positive relationship between pulse pressure and Nt-proBNP to the right (ie, higher blood pressure for a given level of Nt-proBNP). The metabolic syndrome was associated with lower Nt-proBNP levels and shifted the positive relationship between Nt-proBNP and pulse pressure to the right, creating a possible link between the metabolic syndrome and hypertension.

Topics: Adult; Aging; Blood Pressure; Cardiovascular Diseases; Dyslipidemias; Echocardiography; Female; Humans; Hyperinsulinism; Hypertension; Male; Metabolic Syndrome; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Protein Precursors; Risk Factors; Sex Factors; Stroke Volume