Relation of Visceral Adiposity to Circulating Natriuretic Peptides in Ambulatory Individuals
Relation of Visceral Adiposity to Circulating Natriuretic Peptides in Ambulatory Individuals
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DOI：
10.1016/j.amjcard.2011.05.033
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发表时间：
2011-10-01
影响因子：
2.8
通讯作者：
Wang, Thomas J.
中科院分区：
文献类型：
--
作者：
Cheng, Susan;Fox, Caroline S.;Wang, Thomas J.
利钠肽在调节血管紧张素、盐稳态和心室重构中具有重要作用。在肥胖个体中观察到的较低的利钠肽水平可能是与肥胖相关的更大的心血管风险的基础。因此，本研究的目的是确定是否较低的利钠肽水平的肥胖是由于区域脂肪分布的差异。我们调查了1,873名社区个体（46%为女性，平均年龄45岁）血浆N末端B型利钠肽前体（NT pro-BNP）与局部肥胖的关系。皮下脂肪组织（SAT）和内脏脂肪组织（VAT）的体积通过多探测器计算机断层扫描测量。在调整了年龄和血压的性别特异性多变量分析中，男性（β-0.11/标准差增量，p < 0.001）和女性（β-0.19，p < 0.001）的log NT pro-BNP与VAT呈负相关。仅女性中Log NT pro-BNP与SAT呈负相关（β-0.14，p < 0.001）。在包含VAT和SAT的模型中，只有VAT与log NT pro-BNP显著相关（男性，β-0.137，p < 0.001;女性，β-0.184，p < 0.001）。即使在校正了体重指数和腰围（β-0.119，p < 0.001）以及仅限于非肥胖患者的分析（β-0.165，p <0.001）后，VAT仍与log NT pro-BNP相关。调整胰岛素抵抗减弱了NT pro-BNP与VAT和SAT的相关性。总之，本研究表明，循环NT pro-BNP与区域性，特别是内脏性肥胖的变化有关。这些发现表明，过多的内脏脂肪和伴随的高胰岛素血症可能有助于钠尿肽“缺乏症”观察肥胖。(C)2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108：979-984）
Natriuretic peptides have important roles in the regulation of vasomotor tone, salt homeostasis, and ventricular remodeling. Lower natriuretic peptide levels observed in obese individuals may underlie the greater cardiovascular risk associated with obesity. Thus the aim of this study was to determine whether lower natriuretic peptide levels in obesity are attributable to differences in regional fat distribution. We investigated the relation of plasma N-terminal pro B-type natriuretic peptide (NT pro-BNP) to regional adiposity in 1,873 community-based individuals (46% women, mean age 45 years). Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were measured by multidetector computed tomography. In gender-specific multivariable analyses adjusting for age and blood pressure, log NT pro-BNP was inversely associated with VAT in men (beta -0.11 per standard deviation increment, p < 0.001) and women (beta -0.19, p < 0.001). Log NT pro-BNP was inversely associated with SAT in women only (beta -0.14, p < 0.001). In models containing VAT and SAT, only VAT was significantly associated with log NT pro-BNP (men, beta -0.137, p < 0.001; women, beta -0.184, p < 0.001). VAT remained associated with log NT pro-BNP even after adjustment for body mass index and waist circumference (beta -0.119, p < 0.001) and in analyses restricted to nonobese patients (beta -0.165, p < 0.001). Adjustment for insulin resistance attenuated the associations of NT pro-BNP with VAT and SAT. In conclusion, this study demonstrates that circulating NT pro-BNP is related to variations in regional and particularly visceral adiposity. These findings suggest that excess visceral adiposity and concomitant hyperinsulinemia may contribute to the natriuretic peptide "deficiency" observed in obesity. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:979-984)