Longitudinal assessment of N-terminal pro-B-type natriuretic peptide and risk of diabetes in older adults: The cardiovascular health study
| Autor: | Joachim H. Ix, Joseph A.C. Delaney, John S. Gottdiener, Luc Djoussé, Kenneth J. Mukamal, Christopher DeFilippi, Jorge R. Kizer, Ian H. de Boer, Russell P. Tracy, Erika F. Brutsaert, Francis Kim, David S. Siscovick, Mary L. Biggs |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Disease 030204 cardiovascular system & hematology Lower risk Risk Assessment Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Endocrinology Insulin resistance Risk Factors Diabetes mellitus Internal medicine Natriuretic Peptide Brain Natriuretic peptide Diabetes Mellitus Medicine Humans Longitudinal Studies Aged Aged 80 and over Adiponectin business.industry Incidence Middle Aged medicine.disease Cardiovascular Diseases Female business Body mass index Biomarkers Kidney disease |
| Zdroj: | Metabolism: clinical and experimental. 65(10) |
| ISSN: | 1532-8600 |
| Popis: | Introduction Natriuretic peptides have a well-recognized role in cardiovascular homeostasis. Recently, higher levels of B-type natriuretic peptide (BNP) have also been associated with decreased risk of diabetes in middle-aged adults. Whether this association persists into older age, where the pathophysiology of diabetes changes, has not been established, nor has its intermediate pathways. Methods We investigated the relationship between N-terminal (NT)-proBNP and incident diabetes in 2359 older adults free of cardiovascular disease or chronic kidney disease in the Cardiovascular Health Study. Results We documented 348 incident cases of diabetes over 12.6 years of median follow-up. After adjusting for age, sex, race, body mass index, systolic blood pressure, anti-hypertensive treatment, smoking, alcohol use, and LDL, each doubling of NT-proBNP was associated with a 9% lower risk of incident diabetes (HR = 0.91 [95% CI: 0.84–0.99]). Additional adjustment for waist circumference, physical activity, estimated glomerular filtration rate or C-reactive protein did not influence the association. Among putative mediators, HDL and triglycerides, adiponectin, and especially homeostasis model assessment of insulin resistance, all appeared to account for a portion of the lower risk associated with NT-proBNP. Conclusion In older adults without prevalent cardiovascular or kidney disease, higher NT-proBNP is associated with decreased risk of incident diabetes even after adjustment for traditional risk factors. These findings suggest that the metabolic effects of natriuretic peptides persist late in life and offer a potential therapeutic target for prevention of diabetes in older people. |
| Databáze: | OpenAIRE |
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