title: Determinants of low levels of brain natriuretic peptide in morbid obesity.
abstract: morbid obesity is associated with cardiovascular comorbidity. A noteworthy feature of this relationship could regard low levels of brain natriuretic peptide (BNP). The study investigates the relationship between BNP and obesity-related markers in a morbid obese population, along with echocardiographic and vascular parameters.
  
  
  
  in 154 morbid obese patients we evaluated anthropometric parameters, glycometabolic/lipid profile, bioimpedentiometry, echocardiography, visceral fat area and flow-mediated dilation (FMD) by ultrasonography.
  
  
  
  we divided population in two groups on the basis of median BMI levels; patients with higher BMI had significantly lower BNP (p = .008), FMD (p = .014) and HDL-C (p = .001) and showed a more impaired heart function. A similar trend emerged subdividing patients on the basis of median visceral fat area. BNP showed a significant inverse correlation with BMI (p < .001), left ventricular mass (p = .026) and inter-ventricular septum thickness (p = .007) and a significant positive correlation with FMD (p = .008), HDL-C (p = .022), and ejection fraction (p = .013). BMI and triglycerides were independent predictors of BNP levels.
  
  
  
  patients with higher BMI show lower BNP levels associated with greater total body fat amount. The correlation of BNP with endothelium-dependent vasodilation and cardiac impairment could represent another link between obesity and cardiovascular damage.
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Maria Anastasia
authors.initials: MA
authors.lastname: Ricci
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Vuono
authors.affiliation: Internal Medicine Unit, Santa Maria Hospital, Terni, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pucci
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Filippo
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Sokol
authors.initials: S
authors.lastname: Berisha
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gentili
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Daviddi
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ministrini
authors.affiliation: Surgery Department, San Giovanni Battista Hospital, Foligno, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Rondelli
authors.affiliation: Surgery Department, San Giovanni Battista Hospital, Foligno, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Boni
authors.affiliation: Internal Medicine, Department of Medicine, University of Perugia, Italy. Electronic address: graziana.lupattelli@unipg.it.
authors.forename: Graziana
authors.initials: G
authors.lastname: Lupattelli
mesh_terms: D050154:Adiposity; D000328:Adult; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D007558:Italy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009767:Obesity, Morbid / Q000097:blood* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D010044:Outpatient Clinics, Hospital; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: Brain natriuretic peptide; Endothelial dysfunction; Morbid obesity; Obesity cardiomyopathy