The impact of an inverse correlation between plasma B-type natriuretic peptide levels and insulin resistance on the diabetic condition in patients with heart failure

Inoue, Yasunori; Kikuchi, Makoto; Minai, Kosuke; Ogawa, Kazuo; Nagoshi, Tomohisa; Ogawa, Takayuki; Yoshimura, Michihiro

doi:10.1016/j.metabol.2015.09.019

Cited by 23 publications

(26 citation statements)

References 43 publications

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“…BNP is a dynamic variable in HF patients, exhibiting large day‐to‐day fluctuations and cumulative trends that reflect biovariability, the unstable nature of the disease, and likely in addition its attendant co‐morbidities . The HOME study provides further important information on this topic and confirms and extends key observations made previously in the HABIT study, namely the high degree of variability between BNP measures separated by just a few days and increasing as the duration between measurements increases.…”

Section: Discussionsupporting

confidence: 80%

Daily home BNP monitoring in heart failure for prediction of impending clinical deterioration: results from the HOME HF study

McDonald

Troughton

Dahlström

et al. 2018

European J of Heart Fail

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Section: Discussionsupporting

confidence: 80%

Daily home BNP monitoring in heart failure for prediction of impending clinical deterioration: results from the HOME HF study

McDonald

Troughton

Dahlström

et al. 2018

European J of Heart Fail

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“…HIF-1α generally augments the production of BNP, and it is decreased in diabetic patients with obesity [28, 29]. We discussed the precise mechanisms in a previous report [30]. …”

Section: Discussionmentioning

confidence: 99%

Manifold implications of obesity in ischemic heart disease among Japanese patients according to covariance structure analysis: Low reactivity of B-type natriuretic peptide as an intervening risk factor

et al. 2017

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Background/ObjectivesObesity is believed to be one of the major risk factors for cardiovascular disease in Western countries. However, the effects of obesity should be continuously examined in the Japanese population because the average bodily habitus differs among countries. In this study, we collectively examined the significance of obesity and obesity-triggered risk factors including the low reactivity of B-type natriuretic peptide (BNP), for ischemic heart disease (IHD) in Japanese patients.Methods and resultsThe study patients consisted of 1252 subjects (IHD: n = 970; non-IHD: n = 282). Multiple logistic regression analysis revealed that dyslipidemia, hypertension, diabetes, and the low reactivity of BNP were significant risk factors for IHD, but body mass index (BMI) was not. A theoretical path model was proposed by positioning BMI at the top of the hierarchical model. Exploratory factor analysis revealed that BMI did not play a causative role in IHD (P = NS). BMI was causatively linked to other risk factors (P<0.001 for hypertension; P<0.001 for dyslipidemia; P<0.001 for HbA1c; P<0.001 for LogBNP), and these factors played a causative role in IHD (P<0.001 for hypertension; P<0.001 for dyslipidemia; P<0.001 for HbA1c; P<0.001 for LogBNP). The intrinsic power of the low reactivity of BNP induced by high BMI on the promotion of IHD was fairly potent.ConclusionThis study demonstrated that obesity per se is not a strong risk factor for IHD in Japanese patients. However, several important risk factors triggered by obesity exhibited a causative role for IHD. The low reactivity of BNP is a substantial risk factor for IHD.

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“…HOMA-IR (as a parameter of insulin resistance), homeostatic model assessment beta cell function (HOMA-β), and the estimated glomerular filtration rate (eGFR) were calculated as described previously [13, 15, 16]. The definition of Diabetes mellitus (DM), hypertension, and dyslipidemia were described previously [15, 17, 18].…”

Section: Methodsmentioning

confidence: 99%

Possible increase in insulin resistance and concealed glucose-coupled potassium-lowering mechanisms during acute coronary syndrome documented by covariance structure analysis

et al. 2017

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ObjectiveAlthough glucose-insulin-potassium (GIK) therapy ought to be beneficial for ischemic heart disease in general, variable outcomes in many clinical trials of GIK in acute coronary syndrome (ACS) had a controversial impact. This study was designed to examine whether “insulin resistance” is involved in ACS and to clarify other potential intrinsic compensatory mechanisms for GIK tolerance through highly statistical procedure.Methods and resultsWe compared the degree of insulin resistance during ACS attack and remission phase after treatment in individual patients (n = 104). During ACS, homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly increased (P<0.001), while serum potassium levels were transiently decreased (degree of which was indicated by ΔK) (P<0.001). This finding provides a renewed paradox, as ΔK, a surrogate marker of intrinsic GIK cascade activation, probably reflects the validated glucose metabolism during ischemic attack. Indeed, multiple regression analysis revealed that plasma glucose level during ACS was positively correlated with ΔK (P = 0.026), whereas HOMA-IR had no impact on ΔK. This positive correlation between ΔK and glucose was confirmed by covariance structure analysis with a strong impact (β: 0.398, P = 0.015). Intriguingly, a higher incidence of myocardial infarction relative to unstable angina pectoris, as well as a longer hospitalization period were observed in patients with larger ΔK, indicating that ΔK also reflects disease severity of ACS.ConclusionsInsulin resistance most likely increases during ACS; however, ΔK was positively correlated with plasma glucose level, which overwhelmed insulin resistance condition. The present study with covariance structure analysis suggests that there are potential endogenous glucose-coupled potassium lowering mechanisms, other than insulin, regulating glucose metabolism during ACS.

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The impact of an inverse correlation between plasma B-type natriuretic peptide levels and insulin resistance on the diabetic condition in patients with heart failure

Abstract: HF and diabetes tend to worsen with each other; however, the appearance of an association between them was likely blunted due to the considerable effect of NP in counteracting insulin resistance, even during the metabolically harmful condition of HF.

Cited by 23 publications

References 43 publications

Daily home BNP monitoring in heart failure for prediction of impending clinical deterioration: results from the HOME HF study

Daily home BNP monitoring in heart failure for prediction of impending clinical deterioration: results from the HOME HF study

Manifold implications of obesity in ischemic heart disease among Japanese patients according to covariance structure analysis: Low reactivity of B-type natriuretic peptide as an intervening risk factor

Possible increase in insulin resistance and concealed glucose-coupled potassium-lowering mechanisms during acute coronary syndrome documented by covariance structure analysis

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