Plasma brain natriuretic peptide levels in normotensive Type 2 diabetic patients without cardiac disease and macroalbuminuria

Asakawa, Hideki; Fukui, Takeshi; Tokunaga, Katsuto; Kawakami, Fusao

doi:10.1016/s1056-8727(01)00173-8

Cited by 22 publications

(15 citation statements)

References 21 publications

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“…In the present study, the predictive value of NT-proBNP on overall mortality was found to be of at least similar magnitude. The kidney also seems to play a role in the clearance of natriuretic peptides, as reflected in the consistent finding of elevated BNP and NT-proBNP levels in diabetic patients with elevated urinary albumin excretion rates in the present and previous studies [6,[20][21][22]. Our data, however, suggest that only a part of the increased cardiovascular risk in diabetic patients with abnormal urinary albumin excretion rate can be attributed to impaired kidney function, and that NT-proBNP is a risk marker for increased mortality in type 2 diabetic patients with normo-, micro-and macroalbuminuria independently of glomerular filtration rate and level of urinary albumin excretion rate.…”

Section: Discussionsupporting

confidence: 88%

Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes

et al. 2006

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Aims/hypothesis Raised N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with a poor cardiac outcome in non-diabetic populations. Elevated NT-proBNP predicts excess morbidity and mortality in diabetic patients with an elevated urinary albumin excretion rate. This study investigated the prognostic value of NT-proBNP in a cohort of type 2 diabetic patients. Subjects, materials and methods In a prospective observational follow-up study, 315 type 2 diabetic patients with normoalbuminuria (n=188), microalbuminuria (n=80) and macroalbuminuria (n=47) at baseline were followed for a median (range) of 15.5 (0.2-17.0) years. Plasma NTproBNP concentrations were determined by immunoassay at baseline. Endpoints were overall and cardiovascular mortality. Results Of the patients, 162 died (51%), 119 of them (74%) due to cardiovascular causes. All-cause mortality was increased in patients with NT-proBNP .02], p=0.01). When patients with normo-, micro-and macroalbuminuria were analysed separately, NT-proBNP levels above the median (62 ng/l) were consistently associated with increased overall and cardiovascular mortality in all three groups (p<0.001). Conclusions/interpretation In patients with type 2 diabetes, elevated circulating NT-proBNP is a strong predictor of the excess overall and cardiovascular mortality, this predictor status being independent of urinary albumin excretion rate and conventional cardiovascular risk factors.

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Section: Discussionsupporting

confidence: 88%

Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes

et al. 2006

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“…These findings are in partial agreement with our results. On the other hand, in a Japanese study of 100 normotensive patients with type 2 diabetes mellitus, BNP level was not positively associated with microalbuminuria [8]. In another Japanese study of 100 normotensive patients with type 2 diabetes mellitus, BNP level was not associated with proteinuria [9].…”

Section: Discussionmentioning

confidence: 86%

“…In previous epidemiological studies regarding the association BNP and renal function, plasma BNP ranged from 10.8 to 46.3 ng/dL [5][6][7][8][9]. The discrepancies among these studies may be explained, at least in part, by differences in sample size; the definition of renal function; characteristics such as age, sex, race, BMI, prevalence of coronary heart diseases, subclinical heart failure and hypertension; and other confounding factors.…”

Section: Discussionmentioning

confidence: 98%

“…In a Japanese study of diabetic patients without coronary heart diseases, BNP level was positively associated with macroalbuminuria but not microalbuminuria [7]. On the other hand, in two Japanese studies of normotensive patients with type 2 diabetes mellitus, BNP level was not associated with either microalbuminuria [8] or proteinuria [9]. The association between BNP The definition of diabetic retinopathy was based on the Fukuda standard [10].…”

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confidence: 99%

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B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

et al. 2017

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THE LEADING CAUSE OF THE DEATH among patients with renal dysfunction is cardiovascular diseases [1], and the importance of the interaction between the heart and kidneys is widely note [2]. Plasma B-type natriuretic peptide (BNP) releases from the ventricles in response to hemodynamic stress, and BNP is one of the predictive markers for cardiovascular events [3,4].Among patients with type 2 diabetes mellitus, sev- Abstract. Among patients with type 2 diabetes mellitus, the association between B-type natriuretic peptide (BNP) and renal function remains controversial. We therefore investigated this issue among Japanese patients with type 2 diabetes mellitus. This study included 687 Japanese patients with type 2 diabetes mellitus. BNP levels were divided at quartile points on the basis of the distribution. We used four outcomes regarding the renal function: 1) chronic kidney disease (CKD): estimated glomerular filtration rate (eGFR) < 60mL/min/1.72m 2 , 2) advanced CKD: eGFR < 30mL/min/1.72m 2 , 3) microalbuminuria: urinary albumin creatinine ratio (UACR) ≥ 30 mg/g creatinine, and 4) macroalbuminuria: UACR ≥ 300 mg/g creatinine. The prevalence values of CKD, advanced CKD, microalbuminuria, and macroalbuminuria were 27.4, 2.5%, 31.4%, and 9.3%, respectively. Highest BNP (≥ 39.2 ng/mL) was independently positively associated with microalbuminuria and macroalbuminuria (adjusted ORs, 2.61 [95% CI: 1.53-4.49] and 3.45 [95% CI: 1.46-8.72], respectively). High BNP was not associated with advanced CKD or CKD. There was a statistically significant positive exposure-response relationships between the BNP level and advanced CKD, microalbuminuria, and macroalbuminuria (p for trend = 0.047, 0.001, and 0.003, respectively). BNP level may be independently positively associated with advanced CKD, microalbuminuria, and macroalbuminuria but not CKD in Japanese patients with type 2 diabetes mellitus.

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“…The plasma levels of brain natriuretic peptides have so far only been examined in a few studies of patients with type 2 diabetes. A Japanese study found plasma BNP levels to be elevated in 16 microalbuminuric type 2 diabetic patients compared with 47 normoalbuminuric patients or healthy control subjects [18], whereas another Japanese study found elevated plasma levels of BNP in 100 normotensive type 2 diabetic patients compared with healthy controls but similar plasma levels in normoalbuminuric and microalbuminuric patients (n=35 and n=65, respectively) [19].…”

Section: Discussionmentioning

confidence: 97%

Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

et al. 2004

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Aims/hypothesis: We examined whether plasma N-terminal probrain natriuretic peptide (NT-proBNP) predicts cardiovascular outcome in patients with type 2 diabetes. Methods: A total of 160 microalbuminuric type 2 diabetic patients (mean age 55.1 years [SD 7.2], 119 men) were enrolled in the Steno-2 Study examining the effect of multifactorial treatment, and were divided into two groups according to baseline levels of plasma NTproBNP below or above the median for the cohort, which was followed for an average of 7.8 years. Cardiovascular outcome was a composite of cardiovascular mortality, myocardial infarction, stroke, revascularisation procedures in the heart or legs, and amputations. Results: In the whole group, plasma NT-proBNP being above the median was associated with an increased risk of cardiovascular disease during follow-up, with an unadjusted hazard ratio of 4.4 (95% CI 2.3-8.4; p<0.0001). A decrease in plasma NT-proBNP of 10 pg/ml during the first 2 years of intervention was associated with a 1% relative reduction in the primary endpoint (p<0.001). Despite polypharmacological treatment targeting cardiovascular disease, the mean plasma NT-proBNP level increased during followup. Conclusions/interpretation: We conclude that high plasma NT-proBNP is a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria.

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Plasma brain natriuretic peptide levels in normotensive Type 2 diabetic patients without cardiac disease and macroalbuminuria

Cited by 22 publications

References 21 publications

Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes

Plasma N-terminal pro-B-type natriuretic peptide and mortality in type 2 diabetes

B-type natriuretic peptide and renal function in Japanese patients with type 2 diabetes mellitus: The Dogo Study

Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

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