Relationship between obesity and B-type natriuretic peptide levels
Relationship between obesity and B-type natriuretic peptide levels
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DOI：
10.1001/archinte.164.20.2247
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发表时间：
2004-11-08
影响因子：
--
通讯作者：
McCullough, PA
中科院分区：
文献类型：
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作者：
McCord, J;Mundy, BJ;McCullough, PA
背景资料：13型利钠肽（BNP）水平，体重指数（BMI），充血性心力衰竭（CHF）作为一个紧急diagnosis.Methods：在1586名参与者呼吸不正常多国研究谁有急性呼吸困难，1369（86.3%）有BNP值和自我报告的身高和体重之间的关系是未知的。两个独立的心脏病专家蒙面BNP结果裁定的最终diagnosis.Results：充血性心力衰竭被发现在46%的参与者。BMI较高的个体更年轻，检查时水肿更频繁，但CHF与非心源性呼吸困难的可能性相同。在BMI组的最低和最高值，平均+/- SD BNP值有近3倍的差异（分别为516.7 +/- 505.9 vs 176.3 +/- 270.5 pg/mL-P <0.001）。CHF患者和非CHF患者的BMI与log BNP之间的相关性分别为r=-0.34和r=-0.21（均P <0.001）。对一小组CHF患者（n = 62）log BNP结果的多变量分析发现，Fragrance评分（P = 0.002）、估计肾小球滤过率（P = 0.007）、女性（P = 0.03）、纽约心脏协会功能分级（P = 0.09）和第三心音（P = 0.08）是独立预测因素。然而，BMI与log BNP无独立相关性（P = 0.59）。结论：在有和无CHF的患者中，BNP水平与BMI呈负相关。当考虑人口统计学、疾病严重程度和肾功能时，当CHF严重程度的详细信息已知时，BMI与小亚组中的BNP水平无关。
Background: The relationships among 13-type natriuretic peptide (BNP) levels, body mass index (BMI), and congestive heart failure (CHF) as an emergency diagnosis are unknown.Methods: Of 1586 participants in the Breathing Not Properly Multinational Study who had acute dyspnea, 1369 (86.3%) had BNP values and sell-reported height and weight. Two independent cardiologists masked to the BNP results adjudicated the final diagnosis.Results: Congestive heart failure was found in 46% of participants. Individuals with higher BMIs were younger and had more frequent edema on examination but were equally as likely to have CHF vs noncardiac sources of dyspnea. A nearly 3-fold difference was seen in mean +/- SD BNP values at the low and high extremes of the BMI groupings (516.7 +/- 505.9 vs 176.3 +/- 270.5 pg/mL, respectively-P < .001). The correlations between BMI and log BNP among those with and without CHF were r=-0.34 and r=-0.21, respectively (P < .001 for both). Multivariate analysis for the outcome of log BNP among a small subset with CHF (n = 62) found that Framingham score (P = .002), estimated glomerular filtration rate (P = .007), female sex (P = .03), New York Heart Association functional class (P = .09), and third heart sound (P = .08) were independent predictors. However, BMl was not found to be independently related to log BNP (P = .59).Conclusions: In patients with and without CHF, BNP levels are inversely related to BMI. When considering demographics, severity of disease, and renal function, BMI is not independently related to BNP levels in a small subgroup when detailed information about CHF severity is known.