title: N-terminal pro-B-type natriuretic peptide is inversely related to bone mineral density in renal transplant recipients.
abstract: BACKGROUND
  Bone mineral density (BMD) was significantly lower in heart failure patients. Our aim was to evaluate the relationship between BMD and fasting serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration in renal transplant recipients.
  
  
  METHODS
  Fasting blood samples were obtained from 69 renal transplant recipients. BMD was measured by dual energy x-ray absorptiometry in lumbar vertebrae (L2-L4). Serum NT-proBNP levels were measured by electrochemiluminescence immunoassay.
  
  
  RESULTS
  Among the renal transplant recipients, 8 patients (11.6%) had osteoporosis and 28 (40.6%) had osteopenia; 33 had a normal BMD. Increased serum NT-proBNP (P < .001) and decreased body mass index (P = .033) and body weight (P = .010) were significantly correlated with low lumbar T-score cutoff points between groups (normal, osteopenia, and osteoporosis). Women had lower lumbar BMD than did men (P = .013). Menopause in women (P = .005), use of tacrolimus (P = .020), and use of cyclosporine (P = .046) among renal transplant recipients were associated with lower lumbar BMD. Multivariate forward stepwise linear regression analysis of the significant variables revealed that log-transformed NT-proBNP (β, -0.545; R(2) = 0.331; P < .001), and body weight (β, 0.273, R(2) = 0.104; P = .005) were independent predictors of lumbar BMD values among the renal transplant recipients.
  
  
  CONCLUSIONS
  Serum NT-proBNP concentrations correlate negatively with lumbar BMD values among renal transplant recipients and may be an alternative to energy x-ray absorptiometry for identifying at risk of osteoporosis in renal transplant recipients.
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: M-C
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Lee
authors.affiliation: Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: M-H
authors.initials: MH
authors.lastname: Shih
authors.affiliation: Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: G-J
authors.initials: GJ
authors.lastname: Ho
authors.affiliation: Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Chen
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. Electronic address: gee.lily@msa.hinet.net.
authors.forename: B-G
authors.initials: BG
authors.lastname: Hsu
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density / Q000502:physiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010024:Osteoporosis / Q000097:blood* / Q000000981:diagnostic imaging; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors; D066027:Transplant Recipients
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain