Determinants of low levels of brain natriuretic peptide in morbid obesity

Clin Nutr. 2017 Aug;36(4):1075-1081. doi: 10.1016/j.clnu.2016.06.024. Epub 2016 Jul 1.

Abstract

Background & aims: morbid obesity is associated with cardiovascular comorbidity. A noteworthy feature of this relationship could regard low levels of brain natriuretic peptide (BNP). The study investigates the relationship between BNP and obesity-related markers in a morbid obese population, along with echocardiographic and vascular parameters.

Methods: in 154 morbid obese patients we evaluated anthropometric parameters, glycometabolic/lipid profile, bioimpedentiometry, echocardiography, visceral fat area and flow-mediated dilation (FMD) by ultrasonography.

Results: we divided population in two groups on the basis of median BMI levels; patients with higher BMI had significantly lower BNP (p = .008), FMD (p = .014) and HDL-C (p = .001) and showed a more impaired heart function. A similar trend emerged subdividing patients on the basis of median visceral fat area. BNP showed a significant inverse correlation with BMI (p < .001), left ventricular mass (p = .026) and inter-ventricular septum thickness (p = .007) and a significant positive correlation with FMD (p = .008), HDL-C (p = .022), and ejection fraction (p = .013). BMI and triglycerides were independent predictors of BNP levels.

Conclusions: patients with higher BMI show lower BNP levels associated with greater total body fat amount. The correlation of BNP with endothelium-dependent vasodilation and cardiac impairment could represent another link between obesity and cardiovascular damage.

Keywords: Brain natriuretic peptide; Endothelial dysfunction; Morbid obesity; Obesity cardiomyopathy.

MeSH terms

  • Adiposity*
  • Adult
  • Bariatric Surgery
  • Biomarkers / blood
  • Body Mass Index
  • Cross-Sectional Studies
  • Down-Regulation*
  • Female
  • Hospitals, Urban
  • Humans
  • Insulin Resistance
  • Intra-Abdominal Fat / diagnostic imaging*
  • Italy
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Obesity, Morbid / blood*
  • Obesity, Morbid / diagnostic imaging
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / surgery
  • Outpatient Clinics, Hospital
  • Ultrasonography
  • Waist Circumference

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain