B-type natriuretic peptide, a marker of asymptomatic left ventricular dysfunction in type 2 diabetic patients.
OBJECTIVE
To evaluate BNP in assessing LV functions in asymptomatic type 2 diabetic patients.


METHODS
BNP was measured in 91 consecutive patients with type 2 diabetes mellitus. According to Doppler echocardiography, patients were first separated into three categories: normal LV function, or isolated diastolic or systolic LV dysfunction. As some patients with diastolic dysfunction were treated for hypertension, the population was divided into four groups: groups 1, 2 and 3 all had no antihypertensive treatment, and had normal LV function, and isolated diastolic and systolic LV dysfunction, respectively; and group 4 were being treated with antihypertensive drugs and had diastolic LV dysfunction.


RESULTS
In group 1, BNP levels (13+/-2 ng/L) were lower than in group 2 (87+/-20 ng/L, P<0.0001) or group 3 (213+/-32 ng/L, P<0.0001), but were similar to those of group 4 (32+/-6 ng/L, P=0.14). ROC analysis revealed a rule-out value of 23 ng/L for group 1 versus group 2, and of 239 ng/L for group 2 versus group 3. In groups 1, 2 and 3 taken together, BNP levels were correlated with urinary albumin excretion rate (r=0.80, P<0.0001) and pulse pressure (r=0.65, P<0.0001). In group 4, patients receiving ACE inhibitors had lower BNP levels than those receiving ss-blockers.


CONCLUSIONS
BNP can be used to pre-screen asymptomatic type 2 diabetic patients with LV dysfunction, and may reveal vascular remodelling in type 2 diabetes mellitus.
Albertini
J-P
JP
Laboratory of Biochemistry, Avicenne Hospital, AP-HP, 125, route de Stalingrad, 93009 Bobigny cedex, France. jean-paul.albertini@avc.aphp.fr
Cohen
R
R
Valensi
P
P
Sachs
R N
RN
Charniot
J-C
JC
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012044:Regression Analysis; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging
D000959:Antihypertensive Agents; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain