title: Increased plasma levels of N-terminal brain natriuretic peptide (NT-proBNP) in type 2 diabetic patients with vascular complications.
abstract: OBJECTIVE
  The plasma levels of either brain natriuretic peptide (BNP) or the N-terminal fragment of the prohormone (NT-proBNP) have recently gained extreme importance as markers of myocardial dysfunction. Patients with type 2 diabetes are at high risk of developing cardiovascular complications. This study was aimed to assess whether plasma NT-proBNP levels are at similar levels in type 2 diabetics with or without overt cardiovascular diseases.
  
  
  METHODS
  We assayed plasma NT-proBNP in 54 type 2 diabetics, 27 of whom had no overt macro- and/or microvascular complications, while the remaining ones had either or both. The same assay was carried out in 38 healthy control subjects age and sex matched as a group with the diabetics.
  
  
  RESULTS
  Plasma NT-proBNP was higher in diabetics (median 121 pg/ml, interquartile range 50-240 pg/ml, ) than in those without complications (37 pg/ml, 21-54 pg/ml, P<0.01). Compared with the controls (55 pg/ml, 40-79 pg/ml), only diabetics with vascular complications had significantly increased plasma NT-proBNP levels (P<0.001). In the diabetics, coronary heart disease and nephropathy (defined according to urinary excretion of albumin) were each independently associated with elevated values of plasma NT-proBNP.
  
  
  CONCLUSIONS
  In type 2 diabetes mellitus, patients with macro- and/or micro-vascular complications exhibit an elevation of plasma NT-proBNP levels compared to corresponding patients with no evidence of vascular disease. The excessive secretion of this peptide is independently associated with coronary artery disease and overt nephropathy. The measurement of circulating NT-proBNP concentration may therefore be useful to screen for the presence of macro- and/or microvascular disease.
authors.affiliation: Division of Endocrinology, Diabetology and Metabolism, University Hospital, CH-1011 Lausanne, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Beer
authors.forename: S
authors.initials: S
authors.lastname: Golay
authors.forename: D
authors.initials: D
authors.lastname: Bardy
authors.forename: F
authors.initials: F
authors.lastname: Feihl
authors.forename: R C
authors.initials: RC
authors.lastname: Gaillard
authors.forename: C
authors.initials: C
authors.lastname: Bachmann
authors.forename: B
authors.initials: B
authors.lastname: Waeber
authors.forename: J
authors.initials: J
authors.lastname: Ruiz
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D003327:Coronary Disease / Q000097:blood / Q000503:physiopathology; D048909:Diabetes Complications / Q000097:blood / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000503:physiopathology; D010446:Peptide Fragments / Q000097:blood*; D012016:Reference Values
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain