The association of brain natriuretic peptide and insulin resistance in obesity-related hypertension

Abstract

Hypertension is frequently associated with obesity and natriuretic peptide levels are reported to decrease in obese subjects. Both the lower brain natriuretic peptide (BNP) concentration and insulin resistance are suggested to be associated with hypertension. However, their involvement in obesity-related hypertension has not been clearly defined. Forty-four obese women (21 normotensive and 23 hypertensive) and 25 healthy women matched for age were included in the study. Anthropometrical parameters were determined. Serum BNP, fasting insulin and glucose concentrations, and lipid parameters were evaluated. Insulin resistance was calculated using Homeostasis Model Assessment (HOMA) and Quantative Insulin Sensitivity Check Index (QUICKI) formulations. Within the obese groups, HOMA and QUICKI reflected the increased insulin resistance in hypertensive obese subjects with a significant correlation to blood pressure. The decrease in BNP in the obese groups was in favour of the hypertensive obese subjects (31.4376.43; 26.3674.29; and 17.5173.08 pg/ ml, respectively) with a fractional statistical significance between the hypertensive obese group and the controls (P ¼ 0.047). Only for the obese hypertensive group, fasting glucose, HOMA and QUICKI were significantly correlated with BNP. Moreover, fasting plasma glucose (R 2 ¼ 0.22, P ¼ 0.007) and fasting plasma insulin (R 2 ¼ 0.39, P ¼ 0.03) were independently correlated with BNP only for the obese hypertensive group. It can be concluded that the decrease in BNP concentrations in the obese hypertensive subjects seem to be well correlated with the insulin resistance.

The Influence of Metabolic Syndrome Components on N-Terminal Pro B-Type Natriuretic Peptide Concentrations: The Role of Left Ventricular Diastolic Dysfunction

“…The observation that natriuretic peptide levels relate differently to SBP than to other metabolic risk factors is in keeping with studies suggesting that HBP segregates separately from other MSy components (28,29). These data suggest that HBP may share different pathophysiological determinants from other MSy components, which have a closer association with insulin resistance, and may help to explain the different relations with the natriuretic peptides.…”

Relation of Obesity to Circulating B-Type Natriuretic Peptide Concentrations in Blacks

“…22 These findings suggest that perhaps BNP may be more a manifestation of metabolic syndrome rather than related specifically to low BMI. 22,23 …”

N-terminal Prohormone B-type Natriuretic Peptide and Cardiovascular Function in Africans and Caucasians: The SAfrEIC Study

“…NT-proBNP functions as a ventricular cardiac hormone and partakes in the control of myocardial structure and function [7]. It is also involved in the lowering of sodium reabsorption in the kidneys, resulting in decreased blood volume and subsequent arterial pressure [8,9], therefore counteracting left ventricular wall tension and increasing plasma volume [10,11]. In a study of coronary atherosclerosis, plasma NT-proBNP levels were significantly lower in African Americans compared to Caucasians [10,12], but less is known in the bi-ethnic populations of South Africa.…”