Aldosterone, C-Reactive Protein, and Plasma B-Type Natriuretic Peptide Are Associated With the Development of Metabolic Syndrome and Longitudinal Changes in Metabolic Syndrome Components

Musani, Solomon K.; Vasan, Ramachandran S.; Bidulescu, Aurelian; Liu, Jiankang; Xanthakis, Vanessa; Sims, Mario; Gawalapu, Ravi K.; Samdarshi, Tandaw E.; Steffes, Michael W.; Taylor, Herman A.; Fox, Ervin R.

doi:10.2337/dc12-2562

Cited by 56 publications

(55 citation statements)

References 39 publications

(47 reference statements)

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“…This is likely due to differences among examined populations in the relative frequencies of MetS components with opposite effects on BNP. Consistently, a recent longitudinal study performed on 3,019 African Americans has shown that both lower and higher BNP levels were predictors of incident MetS in a nonlinear U-shape relationship, likely a reflection of lower BNP relation to obesity and higher BNP relation to blood pressure (54).…”

Section: Nps and Obesity Diabetes And Diabetes Complications Obesitymentioning

confidence: 58%

Natriuretic Peptides, Heart, and Adipose Tissue: New Findings and Future Developments for Diabetes Research

2014

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Natriuretic peptides (NPs) play a key role in cardiovascular homeostasis, counteracting the deleterious effects of volume and pressure overload and activating antibrotic and antihypertrophic pathways in the heart. N-terminal B-type NP (NT-proBNP) also is a promising biomarker of global cardiovascular risk in the general population, and there is increasing interest on its potential use in diabetic patients for screening of silent cardiovascular abnormalities, cardiovascular risk stratification, and guided intervention. Recently, both atrial NP (ANP) and B-type NP (BNP) have emerged as key mediators in the control of metabolic processes including the heart in the network of organs that regulate energy usage and metabolism. Epidemiological studies have shown that ANP and BNP are reduced in people with obesity, insulin resistance, and diabetes, and this deficiency may contribute to enhance their global cardiovascular risk. Moreover, ANP and BNP have receptors in the adipose tissue, enhance lipolysis and energy expenditure, and modulate adipokine release and food intake. Therefore, low ANP and BNP levels may be not only a consequence but also a cause of obesity, and recent prospective studies have shown that low levels of NT-proBNP and midregional proANP (MR-proANP) are a strong predictor of type 2 diabetes onset. Whether ANP and BNP supplementation may result in either cardiovascular or metabolic benefits in humans remains, however, to be established.Natriuretic peptides (NPs) have gained great interest as indicators of the state of cardiovascular health across the spectrum of cardiovascular diseases (CVD) in diabetic subjects (1-4). Recently, NPs also have emerged as key mediators in the control of metabolic processes (5) and have been implicated in the development of diabetes (6,7), shifting current paradigms and opening novel avenues in diabetes research. This review will summarize new findings in the field and discuss their potential clinical relevance. NPS AND THEIR RECEPTORSNPs are a family of genetically distinct and structurally related peptides, including atrial NP (ANP), B-type NP (BNP), and C-type NP (CNP). They share a similar structural conformation, characterized by a peptide ring with a cysteine bridge, which is well preserved throughout evolution, being the portion of the chain that binds to the receptor. ANP and BNP are predominantly secreted by cardiomyocytes, whereas CNP is mainly produced by the central nervous system, the endothelium, the bone, and the reproductive system (8-11).

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Section: Nps and Obesity Diabetes And Diabetes Complications Obesitymentioning

confidence: 58%

Natriuretic Peptides, Heart, and Adipose Tissue: New Findings and Future Developments for Diabetes Research

2014

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“…37 The natriuretic peptide system also influences lipid and glucose metabolism and homeostasis, further potentially contributing to the prognostic value of BNP. 38–41 …”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Risk Prediction Models for Cardiovascular Events in Black Adults

et al. 2016

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IMPORTANCE Cardiovascular risk assessment is a fundamental component of prevention of cardiovascular disease (CVD). However, commonly used prediction models have been formulated in primarily or exclusively white populations. Whether risk assessment in black adults is dissimilar to that in white adults is uncertain. OBJECTIVES To develop and validate risk prediction models for CVD incidence in black adults, incorporating standard risk factors, biomarkers, and subclinical disease. DESIGN, SETTING, AND PARTICIPANTS The Jackson Heart Study (JHS), a longitudinal community-based study of 5301 black adults in Jackson, Mississippi. Inclusive study dates were the date of a participant’s first visit (September 2000 to March 2004) to December 31, 2011. The median (75th percentile) follow-up was 9.1 (9.7) years. The dates of the analysis were August 2013 to May 2015. Measurements included standard risk factors, including age, sex, body mass index, systolic and diastolic blood pressure, ratio of fasting total cholesterol to high-density lipoprotein cholesterol, estimated glomerular filtration rate, antihypertensive therapy, diabetes mellitus, and smoking; blood biomarkers; and subclinical disease measures, including ankle-brachial index, carotid intimal-medial thickness, and echocardiographic left ventricular hypertrophy and systolic dysfunction. MAIN OUTCOMES AND MEASURES Incident CVD event was defined as the first occurrence of myocardial infarction, coronary heart disease death, congestive heart failure, stroke, incident angina, or intermittent claudication. Model performance was compared with the American College of Cardiology/American Heart Association (ACC/AHA) CVD risk algorithm and the Framingham Risk Score (FHS) refitted to the JHS data and evaluated in the Atherosclerosis Risk in Communities (ARIC) and Multi-Ethnic Study of Atherosclerosis cohorts. RESULTS The study cohort comprised 3689 participants with mean (SD) age at baseline was 53 (11) years, and 64.8% (n = 2390) were female. Over a median of 9.1 years, 270 participants (166 women) experienced a first CVD event. A simple combination of standard CVD risk factors, B-type natriuretic peptide, and ankle-brachial index (model 6) yielded modest improvement over a model without B-type natriuretic peptide and ankle-brachial index (C statistic, 0.79; 95% CI, 0.75–0.83 [relative integrated discrimination improvement, 0.22; 95% CI, 0.15–0.30]). However, the reclassification improvement was not substantially different between model 6 and the ACC/AHA CVD Pooled Cohort risk equations or between model 6 and the FHS. The models discriminated reasonably well in the ARIC and Multi-Ethnic Study of Atherosclerosis data (C statistic range, 0.70–0.77). CONCLUSIONS AND RELEVANCE Our findings using the JHS data in the present study are valuable because they confirm that current FHS and ACC/AHA risk algorithms work well in black individuals and are not easily improved on. A unique risk calculator for black adults may not be necessary.

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“…Population studies performed in Germany [46] and in the USA in Mississippi [47] and Minnesota [48•] demonstrated a positive association between aldosterone levels and the metabolic syndrome. In the Minnesota population, aldosterone also predicted hypertension, central obesity, chronic renal disease, increased triglyceride levels, atrial fibrillation, and concentric left ventricular hypertrophy [48•].…”

Section: Mr and The Cardiovascular And Renovascular Systems Inmentioning

confidence: 99%

Aldosterone and the Mineralocorticoid Receptor: Risk Factors for Cardiometabolic Disorders

Garg

Adler

2015

Curr Hypertens Rep

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Preclinical studies have convincingly demonstrated a role for the mineralocorticoid receptor (MR) in adipose tissue physiology. These studies show that increased MR activation causes adipocyte dysfunction leading to decreased production of insulin-sensitizing products and increased production of inflammatory factors, creating an environment conducive to metabolic and cardiovascular disease. Accumulating data also suggest that MR activation may be an important link between obesity and metabolic syndrome. Moreover, MR activation may mediate the pathogenic consequences of metabolic syndrome. Recent attempts at reversing cardiometabolic damage in patients with type 2 diabetes using MR antagonists have shown promising results. MR antagonists are already used to treat heart failure where their use decreases mortality and morbidity over and above the use of traditional therapies alone. However, more data are needed to establish the benefits of MR antagonists in diabetes, obesity, and metabolic syndrome.

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Aldosterone, C-Reactive Protein, and Plasma B-Type Natriuretic Peptide Are Associated With the Development of Metabolic Syndrome and Longitudinal Changes in Metabolic Syndrome Components

Cited by 56 publications

References 39 publications

Natriuretic Peptides, Heart, and Adipose Tissue: New Findings and Future Developments for Diabetes Research

Natriuretic Peptides, Heart, and Adipose Tissue: New Findings and Future Developments for Diabetes Research

Development and Validation of Risk Prediction Models for Cardiovascular Events in Black Adults

Aldosterone and the Mineralocorticoid Receptor: Risk Factors for Cardiometabolic Disorders

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