title: Relation of visceral adiposity to circulating natriuretic peptides in ambulatory individuals.
abstract: Natriuretic peptides have important roles in the regulation of vasomotor tone, salt homeostasis, and ventricular remodeling. Lower natriuretic peptide levels observed in obese individuals may underlie the greater cardiovascular risk associated with obesity. Thus the aim of this study was to determine whether lower natriuretic peptide levels in obesity are attributable to differences in regional fat distribution. We investigated the relation of plasma N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) to regional adiposity in 1,873 community-based individuals (46% women, mean age 45 years). Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were measured by multidetector computed tomography. In gender-specific multivariable analyses adjusting for age and blood pressure, log NT-pro-BNP was inversely associated with VAT in men (beta -0.11 per standard deviation increment, p <0.001) and women (beta -0.19, p <0.001). Log NT-pro-BNP was inversely associated with SAT in women only (beta -0.14, p <0.001). In models containing VAT and SAT, only VAT was significantly associated with log NT-pro-BNP (men, beta -0.137, p <0.001; women, beta -0.184, p <0.001). VAT remained associated with log NT-pro-BNP even after adjustment for body mass index and waist circumference (beta -0.119, p <0.001) and in analyses restricted to nonobese patients (beta -0.165, p <0.001). Adjustment for insulin resistance attenuated the associations of NT-pro-BNP with VAT and SAT. In conclusion, this study demonstrates that circulating NT-pro-BNP is related to variations in regional and particularly visceral adiposity. These findings suggest that excess visceral adiposity and concomitant hyperinsulinemia may contribute to the natriuretic peptide "deficiency" observed in obesity.
authors.affiliation: Framingham Heart Study, Massachusetts, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McCabe
authors.forename: Abigail May
authors.initials: AM
authors.lastname: Khan
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Karen K
authors.initials: KK
authors.lastname: Miller
authors.forename: Christopher
authors.initials: C
authors.lastname: Newton-Cheh
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Coviello
authors.forename: Shalender
authors.initials: S
authors.lastname: Bhasin
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007118:Immunoassay; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D045265:Natriuretic Peptides / Q000097:blood*; D056128:Obesity, Abdominal / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D010045:Outpatients; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D045265:Natriuretic Peptides; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain