Effect of weight loss after weight loss surgery on plasma N-terminal pro-B-type natriuretic peptide levels.
Effect of weight loss after weight loss surgery on plasma N-terminal pro-B-type natriuretic peptide levels.
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DOI：
10.1016/j.amjcard.2010.06.076
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发表时间：
2010-11-15
影响因子：
2.8
通讯作者：
Wang, Thomas J.
中科院分区：
文献类型：
--
作者：
Chen-Tournoux, Annabel;Khan, Abigail May;Baggish, Aaron L.;Castro, Victor M.;Semigran, Marc J.;McCabe, Elizabeth L.;Moukarbel, George;Reingold, Jason;Durrani, Sofia;Lewis, Gregory D.;Newton-Cheh, Christopher;Scherrer-Crosbie, Marielle;Kaplan, Lee M.;Wang, Thomas J.
利钠肽具有多种有益的心血管作用。先前的横断面研究表明，肥胖个体比正常体重个体具有较低的利钠肽浓度。目前尚不清楚这种相对的利钠肽缺乏症是否会随着体重减轻而逆转。我们研究了132名接受减肥手术的肥胖患者，在术前、术后早期（1-2个月）和晚期（6个月）时间点连续测量血浆N末端B型利钠肽前体（NT-proBNP）浓度。20例受试者还在基线和术后6个月接受了超声心动图检查。术后观察到体重显著减轻（三个时间点的中位体重指数[BMI]分别为45.1、41.0和32.9 kg/m2，ANOVA p<0.001）。中位NT-proBNP水平显著升高（31.6、66.9和84.9 pg/ml; p<0.001）。在两个术后时间点，NT-proBNP的平均个体内增加是术前水平的3.4和5.0倍（两个时间点与术前相比p<0.001）。在调整临床特征和胰岛素抵抗的多变量回归模型中，减肥手术后6个月NT-proBNP水平变化的最强预测因子是体重变化（p=0.03）。超声心动图显示左室质量指数平均降低18%（p<0.001），收缩和舒张功能轻度改善。总之，我们证明，体重减轻与NT-proBNP浓度的早期和持续增加有关，尽管有证据表明收缩和舒张功能改善。这些发现表明肥胖和利钠肽水平降低之间存在直接的、可逆的关系。
Natriuretic peptides have multiple beneficial cardiovascular effects. Prior cross-sectional studies indicate that obese individuals have lower natriuretic peptide concentrations than individuals of normal weight. It is not known whether this relative natriuretic peptide deficiency is reversible with weight loss. We studied 132 obese individuals undergoing weight loss surgery with serial measurement of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations at pre-operative, early (1–2 months) and late post-operative (6 months) time points. Twenty subjects also underwent echocardiography at baseline and 6 months after surgery. Significant weight loss was observed after surgery (median body mass index [BMI] 45.1, 41.0, and 32.9 kg/m2 for the three time points respectively, ANOVA p<0.001). Median NT-proBNP levels increased substantially (31.6, 66.9, and 84.9 pg/ml; p<0.001). The average intra-individual increase in NT-proBNP at the two post-operative time points was 3.4 and 5.0 times the pre-operative level (p<0.001 for both time points versus pre-operative). In multivariable regression models adjusting for clinical characteristics and insulin resistance, the strongest predictor of the change in NT-proBNP level 6 months after weight loss surgery was the change in weight (p=0.03). Echocardiography showed a mean intra-individual reduction in LV mass index of 18% (p<0.001), and mild improvements in systolic and diastolic function. In conclusion, we demonstrate that weight loss is associated with early and sustained increases in NT-proBNP concentrations, despite evidence of improved systolic and diastolic function. These findings suggest a direct, reversible relation between obesity and reduced natriuretic peptide levels.
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DOI：
10.1038/oby.2003.99
发表时间：
2003-06-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Hanusch-Enserer, U;Hermann, KM;Prager, R
通讯作者：
Prager, R
影响因子：
2.8
作者：
ALPERT, MA;TERRY, BE;KELLY, DL
通讯作者：
KELLY, DL
影响因子：
2.8
作者：
Chainani-Wu, Nita;Weidner, Gerdi;Ornish, Dean
通讯作者：
Ornish, Dean
影响因子：
9.8
作者：
Messaoudi, L;Donckier, J;Kolanowski, J
通讯作者：
Kolanowski, J
影响因子：
37.8
作者：
Das, SR;Drazner, MH;de Lemos, JA
通讯作者：
de Lemos, JA