Natriuretic Peptides and Risk of Type 2 Diabetes: Results From the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium

Diabetes Care. 2021 Nov;44(11):2527-2535. doi: 10.2337/dc21-0811. Epub 2021 Sep 14.

Abstract

Objective: Natriuretic peptide (NP) concentrations are increased in cardiovascular diseases (CVDs) but are associated with a lower diabetes risk. We investigated associations of N-terminal pro-B-type NP (NT-proBNP) and midregional proatrial NP (MR-proANP) with incident type 2 diabetes stratified by the presence of CVD.

Research design and methods: Based on the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium, we included 45,477 participants with NT-proBNP measurements (1,707 developed type 2 diabetes over 6.5 years of median follow-up; among these, 209 had CVD at baseline) and 11,537 participants with MR-proANP measurements (857 developed type 2 diabetes over 13.8 years of median follow-up; among these, 106 had CVD at baseline). The associations were estimated using multivariable Cox regression models.

Results: Both NPs were inversely associated with incident type 2 diabetes (hazard ratios [95% CI] per 1-SD increase of log NP: 0.84 [0.79; 0.89] for NT-proBNP and 0.77 [0.71; 0.83] for MR-proANP). The inverse association between NT-proBNP and type 2 diabetes was significant in individuals without CVD but not in individuals with CVD (0.81 [0.76; 0.86] vs. 1.04 [0.90; 1.19]; P multiplicative interaction = 0.001). There was no significant difference in the association of MR-proANP with type 2 diabetes between individuals without and with CVD (0.75 [0.69; 0.82] vs. 0.81 [0.66; 0.99]; P multiplicative interaction = 0.236).

Conclusions: NT-proBNP and MR-proANP are inversely associated with incident type 2 diabetes. However, the inverse association of NT-proBNP seems to be modified by the presence of CVD. Further investigations are warranted to confirm our findings and to investigate the underlying mechanisms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Natriuretic Factor
  • Biomarkers
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Diabetes Mellitus, Type 2* / epidemiology
  • Heart Disease Risk Factors
  • Humans
  • Natriuretic Peptide, Brain
  • Natriuretic Peptides
  • Peptide Fragments
  • Risk Assessment
  • Risk Factors

Substances

  • Biomarkers
  • Natriuretic Peptides
  • Peptide Fragments
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor

Associated data

  • figshare/10.2337/figshare.15173301