Computerized tomography measured liver fat is associated with low levels of N-terminal pro-brain natriuretic protein (NT-proBNP). Multi-Ethnic Study of Atherosclerosis

Otto A. Sanchez, Mariana Lazo-Elizondo, Irfan Zeb, Russell P. Tracy, Ryan Bradley, Daniel A. Duprez, Hossein Bahrami, Carmen A. Peralta, Lori B. Daniels, João A. Lima, Alan Maisel, David R. Jacobs, Mathew J. Budoff

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background and Aims N-terminal pro B-type natriuretic peptide (NT-proBNP) is inversely associated with diabetes mellitus, obesity and metabolic syndrome. We aim to characterize the association between NT-proBNP and nonalcoholic fatty liver disease (NAFLD), a condition strongly associated with metabolic syndrome. Methods 4529 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) free of cardiovascular disease, without self-reported liver disease and not diabetic at their baseline visit in 2000-2002 were included in this analysis. NAFLD was defined by a liver attenuation < 40 HU. Relative prevalence (RP) for NAFLD was assessed adjusted for age, race, and sex, percentage of dietary calories derived from fat, total intentional exercise, alcoholic drinks per week, and interleukin-6 by quintiles of NT-proBNP. Adjusted linear spline model was used to characterize a non-linear association between NT-proBNP and liver fat. The inflection point (IP) was the NT-proBNP concentration where there was a change in slope in the association between liver attenuation and NT-proBNP. Results RP for NAFLD decreased by 30% from the lowest to the highest quintile of NT-proBNP, p = 0.01. We observed an inverse linear association between NT-proBNP and liver fat, which plateaued (IP) at an NT-proBNP concentration of 45 pg/mL. Linear regression coefficient (SE) per unit of NT-proBNP less than and greater than or equal to IP was of 0.05 (0.02), p = 0.001 and 0.0006 (0.0008), p = 0.5, respectively; differences between slopes, p < 0.0001. Conclusions In this cross-sectional study of a community based multiethnic sample of non-diabetic adults, low levels of NT-proBNP are associated with greater prevalence of NAFLD.

Original languageEnglish (US)
Pages (from-to)728-735
Number of pages8
JournalMetabolism: clinical and experimental
Issue number5
StatePublished - May 1 2016

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Inc. All rights reserved.


  • Hounsfield units
  • NT-proBNP
  • Natriuretic peptides
  • Non-alcohol fatty liver disease


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