title: Relationship between obesity and B-type natriuretic peptide levels.
abstract: BACKGROUND
  The relationships among B-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 self-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, BMI 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.
authors.affiliation: Henry Ford Heart and Vascular Institute, Henry Ford Health System, Detroit, Mich., USA.
authors.forename: James
authors.initials: J
authors.lastname: McCord
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Mundy
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hudson
authors.forename: Alan S
authors.initials: AS
authors.lastname: Maisel
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
authors.forename: Philip G
authors.initials: PG
authors.lastname: Steg
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Omland
authors.forename: Cathrine W
authors.initials: CW
authors.lastname: Knudsen
authors.forename: Keisha R
authors.initials: KR
authors.lastname: Sandberg
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis*; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain