title: Inverse association of long-acting natriuretic peptide with metabolic syndrome in congestive heart failure patients.
abstract: OBJECTIVE
  Long-acting natriuretic peptide (LANP) is one of the peptide hormones in atrial natriuretic peptide (ANP) pro-hormone. Low levels of natriuretic peptide may lead to reduced lipolysis and excessive weight gain in obese patients. The aim of this study was to investigate the relationship between fasting serum LANP level and the metabolic syndrome (MetS) among congestive heart failure (CHF) patients.
  
  
  METHODS
  Fasting blood samples were obtained from 186 patients with normal renal function in cardiac clinic outpatients. CHF defined by the American College of Cardiology Foundation and the American Heart Association 2005 Guidelines. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation.
  
  
  RESULTS
  Ninety-eight patients (52.7%) had CHF. There was a tendency of increased fasting LANP levels as the NYHA CHF functional classes increased (p = 0.002). Forty-six of the CHF patients (46.9%) had MetS. Fasting LANP level negatively correlated with MetS among CHF patients (p < 0.001). Univariate linear regression analysis showed that BUN (p = 0.026) positively correlated with fasting serum LANP levels, while body weight (p = 0.009), BMI (p = 0.004), homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.024) and HOMA-β (p = 0.001) negatively correlated with fasting serum LANP levels among the CHF patients. Multivariate forward stepwise linear regression analysis of the significant variables showed that the HOMA-β (R2 change = 0.292, p < 0.001) and HOMA-IR (R2 change = 0.081, p = 0.019) were independent predictors of fasting serum LANP levels in CHF patients.
  
  
  CONCLUSIONS
  LANP level is significantly reduced in CHF patients affected by MetS. HOMA-β and HOMA-IR were independent predictors of serum LANP levels in CHF patients.
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan. gee.lily@msa.hinet.net.
authors.forename: Ji-Hung
authors.initials: JH
authors.lastname: Wang
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Lee
authors.forename: Jen-Che
authors.initials: JC
authors.lastname: Hsieh
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Chen
authors.forename: Bang-Gee
authors.initials: BG
authors.lastname: Hsu