Midregional Proatrial Natriuretic Peptide (MRproANP) is associated with vertebral fractures and low bone density in patients with chronic obstructive pulmonary disease (COPD).

Autor:	Trudzinski FC; Department of Pneumology and Critical Care Medicine), German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Thoraxklinik University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany. Franziska.trudzinski@med.uni-heidelberg.de., Jörres RA; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, German Center for Lung Research (DZL), LMU University Hospital, Ludwig-Maximilians-University (LMU), Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany., Alter P; Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), Philipps University of Marburg (UMR), Marburg, Germany., Watz H; Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany.; Airway Research Center North (ARCN), German Center for Lung Research (DZL), Woehrendamm 80, 22927, Grosshansdorf, Germany., Vogelmeier CF; Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), Philipps University of Marburg (UMR), Marburg, Germany., Kauczor HU; Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany., Thangamani S; Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany., Debic M; Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany., Welte T; Department of Pneumology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany., Behr J; Department of Internal Medicine V, CPC Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Munich, Germany., Kahnert K; Department of Internal Medicine V, CPC Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Munich, Germany.; MediCenterGermering, Germering, Germany., Bals R; Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany., Herr C; Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany., Heußel CP; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik, University Medical Center Heidelberg, Heidelberg, Germany., Biederer J; Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany.; Faculty of Medicine, University of Latvia, Riga, Latvia.; Faculty of Medicine, Christian-Albrechts-Universität Zu Kiel, Kiel, Germany., von Stackelberg O; Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany., Fähndrich S; Department of Pneumology, University Medical Centre Freiburg, Freiburg, Germany., Wouters EFM; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.; Medical Faculty, Sigmund Freud University, Vienna, Austria.; Department of Internal Medicine, Sigmund Freud Private University, Vienna, Austria., Waschki B; LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Pulmonary Research Institute, Woehrendamm 80, 22927, Grosshansdorf, Germany.; Department of Pneumology, Itzehoe Hospital, Itzehoe, Germany., Rabe KF; LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Pulmonary Research Institute, Woehrendamm 80, 22927, Grosshansdorf, Germany., Herth FJF; Department of Pneumology and Critical Care Medicine), German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Thoraxklinik University of Heidelberg, Röntgenstrasse 1, 69126, Heidelberg, Germany., Palm V; Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Respiratory research [Respir Res] 2024 Jul 13; Vol. 25 (1), pp. 274. Date of Electronic Publication: 2024 Jul 13.
DOI:	10.1186/s12931-024-02902-2
Abstrakt:	Background: Patients with COPD are often affected by loss of bone mineral density (BMD) and osteoporotic fractures. Natriuretic peptides (NP) are known as cardiac markers, but have also been linked to fragility-associated fractures in the elderly. As their functions include regulation of fluid and mineral balance, they also might affect bone metabolism, particularly in systemic disorders such as COPD. Research Question: We investigated the association between NP serum levels, vertebral fractures and BMD assessed by chest computed tomography (CT) in patients with COPD. Methods: Participants of the COSYCONET cohort with CT scans were included. Mean vertebral bone density on CT (BMD-CT) as a risk factor for osteoporosis was assessed at the level of TH12 (AI-Rad Companion), and vertebral compression fractures were visually quantified by two readers. Their relationship with N-terminal pro-B-type natriuretic peptide (NT-proBNP), Mid-regional pro-atrial natriuretic peptide (MRproANP) and Midregional pro-adrenomedullin (MRproADM) was determined using group comparisons and multivariable analyses. Results: Among 418 participants (58% male, median age 64 years, FEV 1 59.6% predicted), vertebral fractures in TH12 were found in 76 patients (18.1%). Compared to patients without fractures, these had elevated serum levels (p ≤ 0.005) of MRproANP and MRproADM. Using optimal cut-off values in multiple logistic regression analyses, MRproANP levels ≥ 65 nmol/l (OR 2.34; p = 0.011) and age (p = 0.009) were the only significant predictors of fractures after adjustment for sex, BMI, smoking status, FEV 1 % predicted, SGRQ Activity score, daily physical activity, oral corticosteroids, the diagnosis of cardiac disease, and renal impairment. Correspondingly, MRproANP (p < 0.001), age (p = 0.055), SGRQ Activity score (p = 0.061) and active smoking (p = 0.025) were associated with TH12 vertebral density. Interpretation: MRproANP was a marker for osteoporotic vertebral fractures in our COPD patients from the COSYCONET cohort. Its association with reduced vertebral BMD on CT and its known modulating effects on fluid and ion balance are suggestive of direct effects on bone mineralization. Trial Registration: ClinicalTrials.gov NCT01245933, Date of registration: 18 November 2010. (© 2024. The Author(s).)
Databáze:	MEDLINE
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