Reduced plasma natriuretic peptide levels as a manifestation of the metabolic syndrome

Natriuretic peptides are involved in extracellular volume regulation and cardiovascular remodelling. Although reduced natriuretic peptide levels are reported in obesity, data on the association of plasma natriuretic peptide levels and other metabolic risks are conflicting. For this reason, the association of plasma natriuretic peptide levels with metabolic risk factors, the metabolic syndrome, and insulin resistance was investigated in 3333 participants of the Framingham study free of heart failure. After adjustment for clinical and echocardiographic variables, plasma natriuretic peptide levels were inversely associated with all components of the metabolic syndrome, but for elevated blood pressure. Compared with subjects without metabolic syndrome, B-type natriuretic peptide was 24% lower in men and 29% lower in women with the metabolic syndrome whereas N-terminal pro-atrial natriuretic peptide was 16% lower in men and 18% lower in women with the metabolic syndrome (for all P<0.001). Both B-type natriuretic peptide and N-terminal pro-atrial natriuretic peptide levels were significantly lower in subjects with insulin resistance (HOMA-IR).

Abstract