title: Plasma brain-derived neurotrophic factor and reverse dipping pattern of nocturnal blood pressure in patients with cardiovascular risk factors.
abstract: BACKGROUND
  Basic studies have shown that brain-derived neurotrophic factor (BDNF) has critical roles in the survival, growth, maintenance, and death of central and peripheral neurons, while it is also involved in regulation of the autonomic nervous system. Furthermore, recent clinical studies have suggested potential role of plasma BDNF in the circulatory system.
  
  
  OBJECTIVE
  We investigated the mutual relationships among plasma BDNF, patterns of nocturnal blood pressure changes (dippers, non-dippers, extra-dippers, and reverse-dippers), and cardiac autonomic function as determined by heart rate variability (HRV).
  
  
  METHODS
  This was a cross-sectional study of patients registered in the Hyogo Sleep Cardio-Autonomic Atherosclerosis (HSCAA) Study from October 2010 to November 2012.
  
  
  METHODS
  Two-hundred fifty patients with 1 or more cardiovascular risk factor(s) (obesity, smoking, presence of cardiovascular event history, hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease) were enrolled.
  
  
  RESULTS
  Plasma BDNF levels (natural logarithm transformed) were significantly (p = 0.001) lower in reverse-dipper patients (7.18±0.69 pg/ml, mean ± SD, n = 36) as compared to dippers (7.86±0.86 pg/ml, n = 100). Multiple logistic regression analysis showed that BDNF (odds ratios: 0.417, 95% confidence interval: 0.228-0.762, P = 0.004) was the sole factor significantly and independently associated with the reverse-dippers as compared with dippers. Furthermore, plasma BDNF level was significantly and positively correlated with the time-domain (SDNN, SDANN5, CVRR) and frequency-domain (LF) of HRV parameters. Finally, multiple logistic regression analyses showed that the relationship between plasma BDNF and the reverse-dippers was weakened, yet remained significant or borderline significant even after adjusting for HRV parameters.
  
  
  CONCLUSIONS
  Low plasma BDNF was independently associated with patients showing a reverse-dipper pattern of nocturnal blood pressure, in which an imbalance of cardiac autonomic function may be partly involved.
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kadoya
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Koyama
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Kanzaki
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kurajoh
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Hatayama
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Okazaki
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Takuhito
authors.initials: T
authors.lastname: Shoji
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Moriwaki
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Endocrinology, Metabolism and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
authors.affiliation: Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Namba
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human