Changes in N-terminal pro-B-type natriuretic peptide and incidence of diabetes: The Multi-Ethnic Study of Atherosclerosis (MESA)

O. A. Sanchez, D. A. Duprez, H. Bahrami, C. A. Peralta, L. B. Daniels, J. A. Lima, A. Maisel, A. R. Folsom, D. R. Jacobs

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Aims: This study looked at whether the inverse association of circulating N-terminal pro-B-type natriuretic peptide (NT-proBNP) with incident diabetes is modified by changes in NT-proBNP (δNT-proBNP) levels. Methods: Plasma NT-proBNP was assayed at baseline and 3.2years later (visit 3) in the Multi-Ethnic Study of Atherosclerosis (MESA). δNT-proBNP was calculated as NT-proBNPvisit3-NT-proBNPbaseline. A Poisson distribution was fitted to determine the incidence density of diabetes, adjusted for age, race, gender, educational attainment, antihypertensive medication, total intentional exercise and plasma IL-6 levels. In the primary analysis (n=3236 without diabetes up to visit 3, followed for a mean of 6.3 years), incidence density was regressed for the following categories of baseline NT-proBNP: (1)<54.4pg/mL; (2) 54.4-85.9pg/mL; and (3) 86-54.2pg/mL. This was crossed with categories of δNT-proBNP as medians (ranges): (1) -6.2 (-131-11.7) pg/mL; (2) 19.8 (11.8-30.1) pg/mL; (3) 44.0 (30.2-67.9) pg/mL; and (4) 111.2 (68.0-3749.9) pg/mL. Results: The incidence density of diabetes followed a U-shaped association across categories of δNT-proBNP within categories of baseline NT-proBNP after adjusting for other covariates (. P=. 0.02). At each level of baseline NT-proBNP, the incidence density of diabetes was lowest for small-to-moderate increases in NT-proBNP. Conclusion: This analysis suggests that NT-proBNP has a biphasic association with diabetes in which the risk of incident diabetes decreases within a 'physiological range' of δNT-proBNP, and plateaus or increases as NT-proBNP concentrations increase, probably in response to pathophysiological conditions leading to high levels of NT-proBNP.

Original languageEnglish (US)
Pages (from-to)378-386
Number of pages9
JournalDiabetes and Metabolism
Volume41
Issue number5
DOIs
StatePublished - Nov 2015

Bibliographical note

Funding Information:
This research was supported by contracts N01-HC-95159 to N01-HC-95169 from the US National Heart, Lung, and Blood Institute, grants UL1-TR-000040 and UL1-TR-001079 from the US National Center for Research Resources (NCRR), and Roche Diagnostics. The authors also thank the investigators and staff of the Multi-Ethnic Study of Atherosclerosis (MESA) for their valuable contributions. A full list of MESA investigators and institutions can be found at www.mesa-nhlbi.org/.

Publisher Copyright:
© 2015 Elsevier Masson SAS.

Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.

Keywords

  • Change
  • Diabetes
  • Incidence
  • MESA study
  • NT-proBNP
  • Natriuretic peptides

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