title: Slightly elevated B-type natriuretic peptide levels in a non-heart failure range indicate a worse left ventricular diastolic function in individuals with, as compared with individuals without, type 2 diabetes: the Hoorn Study.
abstract: OBJECTIVE
  Higher plasma B-type natriuretic peptide (BNP) in a non-heart failure (HF) range predicts HF and cardiovascular disease (CVD) mortality in the general population. Heart failure is highly prevalent in type 2 diabetes mellitus (T2DM), but associations of BNP to left ventricular (LV) mass and function in individuals with a different glucose status have not been compared. We therefore aimed to explore (i) the association of BNP levels in a non-HF range with structural and functional markers of LV function, and (ii) possible effect modification by glucose tolerance categories.
  
  
  RESULTS
  Linear regression analyses were performed to investigate associations of BNP with 2D echocardiographic measures of LV mass index, LV systolic function, and markers of LV diastolic function in a population-based study of men and women with normal glucose metabolism (NGM, n = 197), impaired glucose metabolism (IGM, n = 128), or T2DM (n = 204). Patients were aged between 50 and 87 years, had BNP levels below 50 pmol/L, and no LV wall motion abnormalities. B-type natriuretic peptide levels ranged from 0.4 to 46.1 pmol/L, the median was 4.2 pmol/L. Higher BNP was significantly associated with increased LV mass and deteriorated LV diastolic function, but not with LV systolic function. B-type natriuretic peptide was more strongly associated with LV diastolic function in T2DM compared with NGM and IGM.
  
  
  CONCLUSIONS
  B-type natriuretic peptide was associated with LV mass and markers of LV diastolic function, and the association of BNP with the latter appeared to be particularly strong in individuals with T2DM. This implies that the presence or absence of T2DM should be taken into account if BNP levels are used to assess CVD risk.
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. katja.vandenhurk@vumc.nl
authors.forename: Katja
authors.initials: K
authors.lastname: van den Hurk
authors.forename: Marjan
authors.initials: M
authors.lastname: Alssema
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Henry
authors.forename: Coen D
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Michaela
authors.initials: M
authors.lastname: Diamant
authors.forename: Frans
authors.initials: F
authors.lastname: Boomsma
authors.forename: Rob J
authors.initials: RJ
authors.lastname: Heine
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Paulus
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D003971:Diastole; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D015592:Immunoradiometric Assay; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain