N-terminal pro B-type natriuretic peptide and insulin resistance in patients with metabolic syndrome
Main Article Content
Abstract
Background: B-type natriuretic peptide (BNP) and N-terminal pro-atrial natriuretic peptide (NT-proANP) plasma levels are linked to metabolic risk. Metabolic syndrome has been associated with lower levels of N-terminal pro B-type natriuretic peptide (NT-proBNP) and insulin resistance.
Aim: This study aims to evaluate the association between NT-proBNP and insulin resistance, diabetes and cardiovascular (CV) risk factors.
Methods: A total of 183 subjects, aged 25-70 years were included in the study based on the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) guidelines for metabolic syndrome. Anthropometric parameters, subclinical measurements and biochemical markers were measured. Gender-specific comparisons were conducted using unpaired t-tests. Correlation between NT-proBNP and insulin resistance in metabolic syndrome was assessed using regression analysis. A p-value of less than 0.05 was considered statistically significant.
Results: Of the 183 subjects, 58% were male and 42% were female. Key clinical parameters - such as blood pressure, body mass index (35.57±6.02 kg/m²) and waist circumference (95.50±9.75 cm) were measured. Other biochemical parameters, including elevated triglycerides, Low-Density Lipoprotein (LDL) cholesterol and blood sugar levels, as well as reduced insulin and NT-proBNP levels were observed. The study found an inverse relationship between NT-proBNP and insulin levels.
Conclusion: Females exhibited higher levels of NT-proBNP and insulin. This study identified an inverse relationship between NT-proBNP and insulin resistance.
Article Details
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References
2. Beltran-Sanchez H, Harhay MO, Harhay MM, McElligott S. Prevalence and trends of metabolic syndrome in the adult US population, 1999–2010. J Am Coll Cardiol 2013;62(8):697–703.
3. Ruderman NB, Shulman GL. Metabolic syndrome. In: Jameson JL, Groot JD, editors. Endocrinology: adult and pediatric. Elsevier; 2015. p. 752–764.
4. Sinha SK, Goel A, Madaan A, Thakur R, Krishna V, Singh K, et al. Prevalence of metabolic syndrome and its clinical and angiographic profile in patients with naive acute coronary syndrome in North Indian population. J Clin Med Res. 2016; 8:667–73.
5. Lewis GF, Steiner G. Acute effects of insulin in the control of VLDL production in humans. Implications for the insulin-resistant state. Diabetes Care 1996; 19(4): 390–393.
6. Rochlani Y, Pothineni NV, Kovelamudi S, Mehta JL. Metabolic syndrome: pathophysiology, management and modulation by natural compounds. Ther Adv Cardiovasc Dis. 2017 Aug;11(8):215-225.
7. Boden G, Shulman GI. Free fatty acids in obesity and type 2 diabetes: defining their role in the development of insulin resistance and beta-cell dysfunction. Eur J Clin Invest 2002; 32(Suppl. 3): 14–23.
8. National Cholesterol Education Program (NCEP): Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults (2002). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 106, 3143–342.
9. Baldassarre S, Fragapani S, Panero A, Fedele D, Pinach S, Lucchiari M, Vitale AR, Mengozzi G, Gruden G, Bruno G. NTproBNP in insulin-resistance mediated conditions: overweight/obesity, metabolic syndrome and diabetes. The population-based Casale Monferrato Study. Cardiovasc Diabetol. 2017 Sep 25;16(1):119.
10. Alberti KGMM, Zimmet P, Shaw J: Metabolic syndrome: A new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med 2006; 23:469–80. Wallace TM, Matthews DR: The assessment of insulin resistance in man. Diabet Med 2002; 19:527–34.
11. Singh O, Gupta M, Khajuria V. Lipid profile and its relationship with blood glucose levels in Metabolic Syndrome. Natl J Physiol Pharm Pharmacol 2015;5:134-137.
12. Lent-Schochet D., McLaughlin M., Ramakrishnan N., Jialal I. Exploratory Metabolomics of Metabolic Syndrome: A Status Report. World J. Diabetes. 2019; 10:23–36.
13. Scott CL: Diagnosis, prevention and intervention for the metabolic syndrome. Am J Cardiol 2003; 92:35–42
14. Hall J.E., Mouton A.J., da Silva A.A., Wang Z., Li X., do Carmo J.M. Obesity, Kidney Dysfunction and Inflammation: Interactions in Hypertension. Cardiovasc. Res. 2021; 117:1859–1876.
15. Avramoglu RK, Basciano H, Adeli K: Lipid and lipoprotein dysregulation in insulin resistant states. Clinica Chimica Acta 2006; 368:1–19
16. Deedwania P, Barter P, Carmena R, Fruchart JC, Grundy SM, Haffner S, Kastelein JJ, LaRosa JC, Schachner H, Shepherd J, Waters DD, Treating to New Targets Investigators: Reduction of low-density lipoprotein cholesterol in patients with coronary heart disease and metabolic syndrome: Analysis of the Treating to New Targets study. Lancet 2006; 368:919–28
17. Maheux P, Azhar S, Kern PA, Chen YD, Reuven GM. Relationship between insulin-mediated glucose disposal and regulation of plasma and adipose tissue lipoprotein lipase. Diabetologia. 1997; 40:850–8.
18. Assmann G, Gotto AM Jr. HDL Cholesterol and protective factors in atherosclerosis. Circulation. 2004;109: III-8–III-14.
19. Pandya H, Lakhani JD, Dadhania J, Trivedi A. The prevalence and pattern of dyslipidemia among type 2 diabetic patients at rural based hospital in Gujarat, India. Indian J Clin Pract. 2012;22(12):36–44
20. Wilcox G. Insulin and insulin resistance. Clin Biochem Rev. 2005;26(2):19.
21. Vasques AC, Rosado LH, Alfenas RC, Geleneze B. Critical analysis on the use of the homeostasis hodel assessment (HOMA) indexes in the evaluation of the insulin resistance and the pancreatic beta cells functional capacity. Arq Bras Endocrinol Metab. 2008;52(1):32-9.
22. George L, Bacha F, Lee S, Tfayli H, Andreatta E, Arslanian S. Surrogate estimates of insulin sensitivity in obese youth along the spectrum of glucose tolerance from normal to prediabetes to diabetes. J Clin Endocrinol Metab. 2011;96:2136–2145.
23. Stern SE, Williams K, Ferrannini E, DeFronzo RA, Bogardus C, Stern MP. Identification of individuals with insulin resistance using routine clinical measurements. Diabetes. 2005;54(2):333-9. PMID: 15677489.
24. Esteghamati A, Khalilzadeh O, Abbasi M, Nakhjavani M, Novin L, Esteghamati AR. HOMA-estimated insulin resistance is associated with hypertension in Iranian diabetic and non-diabetic subjects. Clin Exp Hypertens. 2008; 30:297–307.
25. Akande TO, Adeleye JO, Kadiri S. Insulin resistance in Nigerians with essential hypertension. Afr Health Sci. 2013;13:655–60.
26. Lentner M, Harreiter J. Sex differences in type 2 diabetes. Diabetologia. 2023;66:986–1002.
27. S. Baldassarre, S. Fragapani, A. Panero et al., “NTproBNP in insulin-resistance mediated conditions: overweight/obesity, metabolic syndrome and diabetes. -e population-based Casale Monferrato Study,” Cardiovascular Diabetology, vol. 16, no. 1, p. 119, 2017.
28. H.-R. Chang, J.-C. Hsieh, M. Y.-C. Chen et al., “N-terminal pro- B-type natriuretic peptide is inversely associated with metabolic syndrome in hypertensive patients,”:e American Journal of the Medical Sciences, vol. 348, no. 3, pp. 210–214, 2014.
29. Paweł Krzesinski, Wiesław Piechota, Katarzyna Piotrowicz, Grzegorz Gielerak, Agnieszka Wozniak-Kosek. Association of Estimated Insulin Resistance with N-Terminal B-Type Natriuretic Peptide Concentration in Men with Metabolic Syndrome. Cardiology Research and Practice. Volume 2019, Article ID 8571795, 6 pages
30. Bonora, E.; Tuomilehto, J. The pros and cons of diagnosing diabetes with A1C. Diabetes Care 2011, 34 (Suppl. 2), S184–S190.