Impact of age and sex on plasma natriuretic peptide levels in healthy adults
Impact of age and sex on plasma natriuretic peptide levels in healthy adults
复制标题
DOI：
10.1016/s0002-9149(02)02464-5
复制
发表时间：
2002-08-01
影响因子：
2.8
通讯作者：
Vasan, RS
中科院分区：
文献类型：
--
作者：
Wang, TJ;Larson, MG;Vasan, RS
利钠肽检测作为充血性心力衰竭和左心室功能障碍的潜在筛查试验已受到相当大的关注。然而，关于年龄、性别和其他生理特征对利钠肽水平影响的信息有限。我们检查了911例来自Frachial Heart研究的健康参考样本（平均年龄55岁，62%为女性），这些受试者无高血压、瓣膜病、糖尿病、房颤、肥胖、冠心病、充血性心力衰竭和肾衰竭，左心室收缩功能正常。测定血浆脑钠肽和N-末端心房钠肽水平，并采用多变量回归分析评估钠肽水平的相关性。较高的利钠肽水平的最强预测因子是年龄较大和女性。其他多变量预测因子包括舒张压降低（脉压升高）、体重指数降低和左心房增大。然后根据所有年龄组中按性别和按年龄划分的利钠肽水平的经验分布制定参考限值。与年龄特异性限值相比，将较高比例的健康老年受试者（17% vs 2.5%）归类为“异常”的健康年轻受试者比例较低（1% vs 2.5%）。“我们的结论是，对利钠肽水平的解释应该考虑性别和年龄。从这个大的，健康的社区为基础的样本中得出的参考限值将有助于在临床实践中确定升高的利钠肽水平。(C)2002年，Excerpta Medica，Inc.
Assays for natriuretic peptides have received considerable attention as potential screening tests for congestive heart failure and left ventricular dysfunction. However, information regarding the impact of age, sex, and other physiologic characteristics on natriuretic peptide levels is limited. We examined a healthy reference sample of 911 subjects (mean age 55 years, 62% women) from the Framingham Heart Study who were free of hypertension, valvular disease, diabetes, atrial fibrillation, obesity, coronary heart disease, congestive heart failure, and renal failure, and who had normal left ventricular systolic function. Plasma brain natriuretic peptide and N-terminal atrial natriuretic peptide levels were measured, and multivariable regression used to assess correlates of natriuretic peptide levels. The strongest predictors of higher natriuretic peptide levels were older age and female sex. Other multivariable predictors included lower diastolic blood pressure (higher pulse pressure), lower body mass index, and higher left atrial size. Reference limits were then formulated based on the empirical distribution of natriuretic peptide levels by gender both across all ages and partitioned by age. Age-pooled reference limits compared with age-specific limits classified a higher proportion of healthy elderly subjects (17% vs 2.5%), but a lower proportion of healthy young subjects (1% vs 2.5%) as "abnormal." We conclude that interpretation of natriuretic peptide levels should take into consideration gender and possibly age. The reference limits derived from this large, healthy community-based sample will aid in the identification of elevated natriuretic peptide levels in clinical practice. (C) 2002 by Excerpta Medica, Inc.