title: Visceral fat is negatively associated with B-type natriuretic peptide levels in patients with advanced type 2 diabetes.
abstract: OBJECTIVE
  The association between BMI and low levels of B-type natriuretic peptide (BNP), a marker of heart failure, has been demonstrated in a large population-based cohort. We examined the effects of obesity on BNP levels in patients with diabetes that are often associated with obesity and a higher risk for heart failure.
  
  
  METHODS
  Plasma BNP levels, BMI, and cardiac function parameters were measured in 608 patients with type 2 diabetes. A computed tomography scan was performed to measure abdominal fat.
  
  
  RESULTS
  In multivariable regression analyses adjusted for age, sex, systolic blood pressure, pulse rate, serum creatinine, asynergy, left atrial dimension, percent fractional shortening, and left ventricular mass, there was an inverse relationship between BMI and BNP (p<0.001). Obese individuals with 25</=BMI<30 and 30</=BMI individuals were more likely to have lower BNP levels compared with BMI<22 individuals (multivariable-adjusted odds ratios (95% CIs): 1.61 (1.16-2.26) and 2.07 (1.35-3.22), respectively). Inverse associations were noted between BNP and visceral fat area (VFA) in both sexes (p=0.029 for men, p=0.024 for women).
  
  
  CONCLUSIONS
  In patients with type 2 diabetes, BNP levels are significantly lower in obese subjects after multivariable adjustments. Among various obesity parameters, visceral fat was most closely associated with BNP levels.
authors.affiliation: Department of Atherosclerosis and Diabetes, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Sugisawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kishimoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kokubo
authors.forename: Ayako
authors.initials: A
authors.lastname: Nagumo
authors.forename: Hisashi
authors.initials: H
authors.lastname: Makino
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Yasunao
authors.initials: Y
authors.lastname: Yoshimasa
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*
chemical_list: D020097:Natriuretic Peptide, Brain