Plasma Brain Natriuretic Peptide Levels in Normotensive Noninsulin-Dependent Diabetic Patients with Microalbuminuria

Yano, Yutaka; Katsuki, Akira; Gabazza, Esteban C.; Ito, Kuninobu; Fujii, Masashi; Fukuda, Masahiko; Tuchihashi, Ken; Goto, Hiroyuki; Nakatani, Kaname; Hori, Yasuko; Sumida, Yasuhiro; Adachi, Yukihiko

doi:10.1210/jcem.84.7.5819

Cited by 60 publications

(51 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 88%

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

et al. 2006

View full text Add to dashboard Cite

show abstract

“…In a Japanese study of normotensive, lean patients with type 2 diabetes mellitus, BNP level was positively associated with UACR [5]. A positive association between BNP level and UACR was found in a Japanese study of 316 patients with type 2 diabetes mellitus [6].…”

Section: Discussionmentioning

confidence: 80%

“…In a Japanese study, BNP levels among diabetic patients with microalbuminuria were higher than in those without [5]. BNP level was significantly positively associated with urinary albumin-creatinine ratio (UACR) in a Japanese study of patients with type 2 diabetes mellitus [6].…”

mentioning

confidence: 88%

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

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

“…Elevated plasma levels of ANP and BNP are reported in patients with diabetic nephropathy [14][15][16]. Plasma BNP and pro-BNP also serve as powerful risk markers for cardiovascular disease in patients with diabetic nephropathy [17].…”

mentioning

confidence: 99%

Transgenic overexpression of brain natriuretic peptide prevents the progression of diabetic nephropathy in mice

et al. 2006

View full text Add to dashboard Cite

Aims/hypothesis Brain natriuretic peptide (BNP) is a potent vasorelaxing and natriuretic peptide that is secreted from the heart and has cardioprotective properties. We have previously generated hypotensive transgenic mice (BNP-Tg mice) that overproduce BNP in the liver, which is released into the circulation. Using this animal model, we successfully demonstrated the amelioration of renal injury after renal ablation and in proliferative glomerulonephritis. Glomerular hyperfiltration is an early haemodynamic derangement, representing one of the key mechanisms of the pathogenesis of diabetic nephropathy. Based on the suggested involvement of increased endogenous natriuretic peptides, the aim of this study was to investigate their role in the development and progression of diabetic nephropathy. Materials and methods We evaluated the progression of renal injury and fibrogenesis in BNP-Tg mice with diabetes induced by streptozotocin. We also investigated the effect of BNP on high glucose-induced signalling abnormalities in mesangial cells. Results After induction of diabetes, control mice exhibited progressively increased urinary albumin excretion with impaired renal function, whereas these changes were significantly ameliorated in BNP-Tg mice. Notably, diabetic BNP-Tg mice revealed minimal mesangial fibrogenesis with virtually no glomerular hypertrophy. Glomerular upregulation of extracellular signal-regulated kinase, TGF-β and extracellular matrix proteins was also significantly inhibited in diabetic BNP-Tg mice. In cultured mesangial cells, activation of the above cascade under high glucose was abrogated by the addition of BNP. Conclusions/interpretation Chronic excess of BNP prevents glomerular injury in the setting of diabetes, suggesting that renoprotective effects of natriuretic peptides may be therapeutically applicable in preventing the progression of diabetic nephropathy.

show abstract

Plasma Brain Natriuretic Peptide Levels in Normotensive Noninsulin-Dependent Diabetic Patients with Microalbuminuria

Cited by 60 publications

References 29 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

Transgenic overexpression of brain natriuretic peptide prevents the progression of diabetic nephropathy in mice

Contact Info

Product

Resources

About