Brain natriuretic peptide and insulin resistance in older adults

被引：11

作者：

Kim, F. ^{[1
]}

Biggs, M. L. ^{[2
]}

Kizer, J. R. ^{[3
,4
]}

Brutsaert, E. F. ^{[3
,4
]}

de Filippi, C. ^{[5
]}

Newman, A. B. ^{[6
]}

Kronmal, R. A. ^{[2
]}

Tracy, R. P. ^{[7
]}

Gottdiener, J. S. ^{[5
]}

Djousse, L. ^{[8
,9
]}

de Boer, I. H. ^{[1
]}

Psaty, B. M. ^{[10
,11
]}

Siscovick, D. S. ^{[12
]}

Mukamal, K. J. ^{[13
]}

机构：

[1] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA

[2] Univ Washington, Sch Publ Hlth & Community Med, Dept Biostat, Seattle, WA 98195 USA

[3] Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA

[4] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA

[5] Univ Maryland, Sch Med, Baltimore, MD 21201 USA

[6] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA

[7] Univ Vermont, Coll Med, Dept Pathol & Biochem, Burlington, VT USA

[8] Brigham & Womens Hosp, Div Aging, 75 Francis St, Boston, MA 02115 USA

[9] Harvard Med Sch, Boston, MA USA

[10] Univ Washington, Dept Med Epidemiol & Hlth Serv, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA

[11] Grp Hlth Cooperat Puget Sound, Grp Hlth Res Inst, Seattle, WA USA

[12] New York Acad Med, New York, NY USA

[13] Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA

来源：

DIABETIC MEDICINE | 2017年 / 34卷 / 02期

关键词：

SENSITIVITY; ASSOCIATION; GLUCOSE; DESIGN; INDEX;

D O I：

10.1111/dme.13139

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

AimsHigher levels of brain natriuretic peptide (BNP) have been associated with a decreased risk of diabetes in adults, but whether BNP is related to insulin resistance in older adults has not been established. MethodsN-terminal of the pro hormone brain natriuretic peptide (NT-pro BNP) was measured among Cardiovascular Health Study participants at the 1989-1990, 1992-1993 and 1996-1997 examinations. We calculated measures of insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), Gutt index, Matsuda index] from fasting and 2-h concentrations of glucose and insulin among 3318 individuals with at least one measure of NT-proBNP and free of heart failure, coronary heart disease and chronic kidney disease, and not taking diabetes medication. We used generalized estimating equations to assess the cross-sectional association of NT-proBNP with measures of insulin resistance. Instrumental variable analysis with an allele score derived from nine genetic variants (single nucleotide polymorphisms) within or near the NPPA and NPPB loci was used to estimate an un-confounded association of NT-proBNP levels on insulin resistance. ResultsLower NT-proBNP levels were associated with higher insulin resistance even after adjustment for BMI, waist circumference and other risk factors (P < 0.001 for all four indices). Although the genetic score was strongly related to measured NT-proBNP levels amongst European Americans (F statistic = 71.08), we observed no association of genetically determined NT-proBNP with insulin resistance (P = 0.38; P = 0.01 for comparison with the association of measured levels of NT-proBNP). ConclusionsIn older adults, lower NT-proBNP is associated with higher insulin resistance, even after adjustment for traditional risk factors. Because related genetic variants were not associated with insulin resistance, the causal nature of this association will require future study.

引用

页码：235 / 238

页数：4

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