title: Higher natriuretic peptide levels associate with a favorable adipose tissue distribution profile.
abstract: OBJECTIVE
  The goal of this study was to investigate the association between natriuretic peptides and body fat distribution in a multiethnic cohort.
  
  
  BACKGROUND
  Natriuretic peptides stimulate lipolysis, reduce weight gain, and promote adipocyte browning in animal models, but data are lacking in humans.
  
  
  METHODS
  A total of 2,619 participants without heart failure in the Dallas Heart Study underwent measurements of 1) B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP); and 2) body fat distribution by dual energy x-ray absorptiometry and magnetic resonance imaging. Cross-sectional associations of natriuretic peptides with adiposity phenotypes were examined after adjustment for age, sex, race, comorbidities, and body mass index.
  
  
  RESULTS
  Median BNP and NT-proBNP levels in the study cohort (mean age 44 years; 56% women, 48% African Americans, 32% obese) were 3.0 and 28.1 pg/ml, respectively. Natriuretic peptide levels above the median were associated with a more favorable body fat profile and less insulin resistance, including lower visceral fat, liver fat, and homeostasis model assessment of insulin resistance index, and increased lower body fat and higher adiponectin (p < 0.05 for each). In multivariable analyses, NT-proBNP remained inversely associated with visceral fat (beta coefficient = -0.08; p < 0.0001) and liver fat (beta coefficient = -0.14; p < 0.0001) and positively associated with lower body fat (beta coefficient = 0.07; p < 0.0001) independent of age, sex, race, and obesity status; findings were similar with BNP. Adjustment for body composition, homeostasis model assessment of insulin resistance index, circulating androgens, and adipocytokines did not attenuate the associations.
  
  
  CONCLUSIONS
  Higher natriuretic peptide levels were independently associated with a favorable adiposity profile, characterized by decreased visceral and liver fat and increased lower body fat, suggesting a link between the heart and adipose tissue distribution mediated through natriuretic peptides.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA. ian.neeland@utsouthwestern.edu
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Neeland
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Winders
authors.forename: Colby R
authors.initials: CR
authors.lastname: Ayers
authors.forename: Sandeep R
authors.initials: SR
authors.lastname: Das
authors.forename: Alice Y
authors.initials: AY
authors.lastname: Chang
authors.forename: Jarett D
authors.initials: JD
authors.lastname: Berry
authors.forename: Amit
authors.initials: A
authors.lastname: Khera
authors.forename: Darren K
authors.initials: DK
authors.lastname: McGuire
authors.forename: Gloria L
authors.initials: GL
authors.lastname: Vega
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.forename: Aslan T
authors.initials: AT
authors.lastname: Turer
mesh_terms: D015502:Absorptiometry, Photon; D054392:Adipokines / Q000097:blood; D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000728:Androgens / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D013739:Testosterone / Q000097:blood
chemical_list: D054392:Adipokines; D000728:Androgens; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D013739:Testosterone
keywords: B-type natriuretic peptide; BMI; BNP; BSA; CVD; GFR; HOMA-IR; LV; LVH; MRI; N-terminal pro–B-type natriuretic peptide; NPR; NT-proBNP; body fat distribution; body mass index; body surface area; cardiovascular disease; glomerular filtration rate; homeostasis model assessment of insulin resistance index; insulin resistance; left ventricular; left ventricular hypertrophy; magnetic resonance imaging; natriuretic peptide receptors; natriuretic peptides; visceral fat