title: N-terminal pro-B-type natriuretic peptide in early and advanced phases of obesity.
abstract: BACKGROUND
  Increased plasma amino-terminal-cleavage-fragment of NP (NT-proBNP) is an established indicator for heart failure. Moreover, obese adults had low circulating NT-proBNP suggesting an obesity-related dysregulation (natriuretic handicap). Secretion and/or clearance of NT-proBNP were discussed to be impaired in obesity. As only older adults were investigated so far, it remains unclear when during the evolution of obesity the state of a natriuretic handicap develops, and whether NT-proBNP may still serve as a relevant cardiac marker in obese juveniles.
  
  
  METHODS
  We analysed NT-proBNP in juvenile (n=274, 10-18 years) and middle-aged (n=277, 18-50 years) normal weight (n=213) and obese (n=338) probands together with complex anthropometry, carotis sonography, clinical, and laboratory parameters.
  
  
  RESULTS
  NT-proBNP showed a significant gender and age interaction. Adult females had significant higher NT-proBNP than adult males, and higher levels than juvenile females. Adult males had lower levels than juvenile males. Only a weak age and weight interaction was seen with obese juveniles which showed higher NT-proBNP than obese adults. Moreover, normal weight probands had higher NT-proBNP than overweight and obese. In a multiple regression including all probands, gender, creatinine and uric acid were the best predictors for NT-proBNP. In adults, female gender is the strongest driver for increased NT-proBNP.
  
  
  CONCLUSIONS
  These results argue against an essential influence of obesity to B-type cardiac natriuretic hormone system regulation in the absence of heart failure, and suggest NT-proBNP as a useful cardiac marker irrespective of age and obesity.
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Graz, Austria. harald.mangge@klinikum-graz.at
authors.forename: Harald
authors.initials: H
authors.lastname: Mangge
authors.forename: Gunter
authors.initials: G
authors.lastname: Almer
authors.forename: Sieglinde
authors.initials: S
authors.lastname: Zelzer
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Vasan
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kraigher-Krainer
authors.forename: Robert
authors.initials: R
authors.lastname: Gasser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schnedl
authors.forename: Rottraut
authors.initials: R
authors.lastname: Ille
authors.forename: Sandra
authors.initials: S
authors.lastname: Wallner
authors.forename: Reinhard
authors.initials: R
authors.lastname: Möller
authors.forename: Renate
authors.initials: R
authors.lastname: Horejsi
authors.forename: Daniel
authors.initials: D
authors.lastname: Weghuber
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D002648:Child; D018450:Disease Progression; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology; D010446:Peptide Fragments / Q000097:blood*; D012044:Regression Analysis; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain