title: Obese patients have lower B-type and atrial natriuretic peptide levels compared with nonobese.
abstract: Obesity is a risk factor for the development of heart failure, but the causal mechanism remains unclear. Impaired production or enhanced clearance of natriuretic peptides, which regulate sodium balance and sympathetic activation, may play an important role. The authors investigated the relationship of plasma B-type natriuretic peptide and atrial natriuretic peptide levels to body mass index in 100 patients referred for left heart catheterization. Hemodynamic and echocardiographic data were obtained for all study participants. Atrial natriuretic peptide and B-type natriuretic peptide levels were compared in obese (body mass index > or = 30 kg/m2) and nonobese (body mass index < 30 kg/m2) subjects. Multivariate regression analyses were performed, adjusting for clinical and hemodynamic covariates. Obese patients had significantly lower B-type natriuretic peptide (p = 0.03) and atrial natriuretic peptide (p = 0.04) levels compared with nonobese. Multivariate analysis revealed lower B-type natriuretic peptide (p = 0.095) and atrial natriuretic peptide (p = 0.007) levels in obese patients while controlling for age, sex, left ventricular end-diastolic pressure, and left ventricular ejection fraction. Low levels of circulating natriuretic peptides are thus associated with obesity and may contribute to the development of heart failure.
authors.affiliation: Department of Medicine, Division of Cardiology, University of California, San Francisco, San Francisco, CA 94143-0124, USA.
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Khush
authors.forename: Ivor L
authors.initials: IL
authors.lastname: Gerber
authors.forename: Barry
authors.initials: B
authors.lastname: McKeown
authors.forename: Gregory
authors.initials: G
authors.lastname: Marcus
authors.forename: Joshua
authors.initials: J
authors.lastname: Vessey
authors.forename: Elyse
authors.initials: E
authors.lastname: Foster
authors.forename: Kanu
authors.initials: K
authors.lastname: Chatterjee
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Michaels
mesh_terms: D009320:Atrial Natriuretic Factor / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000503:physiopathology*; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor