title: Determinants of N-terminal proatrial natriuretic peptide plasma levels in a survey of adult male population from Southern Italy.
abstract: OBJECTIVE
  Natriuretic peptides control cardiovascular functions through diuretic, natriuretic, and vasodilatory properties. Several anthropometric, cardiac and renal variables were found to be independently correlated to their levels. Few studies, however, systematically investigated the independent determinants of natriuretic peptide levels in large populations.
  
  
  METHODS
  The present analysis was carried out in a large unselected sample of adult male population in Southern Italy (The Olivetti Heart Study, n = 806 men, mean age = 59.5, range 35-82 years). We examined the relationship of plasma natriuretic peptide-proatrial natriuretic peptide (NT-proANP) levels with relevant anthropometric, clinical and biochemical variables; the impact of age; and the association of NT-proANP levels with cardiovascular risk.
  
  
  RESULTS
  NT-proANP was directly associated to age, pulse pressure (PP), renal sodium fractional excretion (FENa) (P < 0.005), and inversely to diastolic blood pressure (DBP), heart rate (HR), creatinine clearance, body mass index (BMI), arm and leg circumferences (P < 0.005). After adjustment for age, DBP, creatinine clearance, FENa and HR remained independent determinants of NT-proANP levels (all P < 0.01, cumulative R = 0.186). Upon stratification of our population by tertile of age, NT-proANP was significantly associated (P <or= 0.01) to arm circumference in the lowest age tertile (mean age 53.8 years), and to FENa, DBP and creatinine clearance in the highest tertile (mean age 66.7 years). A direct significant association between NT-proANP levels and cardiovascular risk score, estimated by two independent algorithms, was observed (P < 0.001).
  
  
  CONCLUSIONS
  Anthropometric, cardiovascular and renal factors exerted a different impact on NT-proANP levels at different ages in our study population. Higher NT-proANP levels were associated with increased cardiovascular risk.
authors.affiliation: IRCCS Neuromed, Polo Molisano University Sapienza of Rome, Pozzilli Is, Rome, Italy. rubattu.speranza neuromed.it
authors.forename: Speranza
authors.initials: S
authors.lastname: Rubattu
authors.forename: Antonio
authors.initials: A
authors.lastname: Barbato
authors.forename: Simona
authors.initials: S
authors.lastname: Marchitti
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacone
authors.forename: Sara
authors.initials: S
authors.lastname: Di Castro
authors.forename: Anna
authors.initials: A
authors.lastname: Evangelista
authors.forename: Rosita
authors.initials: R
authors.lastname: Stanzione
authors.forename: Renato
authors.initials: R
authors.lastname: Ippolito
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Sciarretta
authors.forename: Luigi
authors.initials: L
authors.lastname: Palmieri
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.forename: Pasquale
authors.initials: P
authors.lastname: Strazzullo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D003404:Creatinine / Q000652:urine; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D012964:Sodium / Q000652:urine
chemical_list: C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor; D012964:Sodium; D003404:Creatinine