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NH(2)-Terminal Probrain Natriuretic Peptide Is Associated With Diabetes Complications in the EURODIAB Prospective Complications Study: The role of tumor necrosis factor-α

OBJECTIVE: Circulating levels of NH(2)-terminal probrain natriuretic peptide (NT-proBNP), a marker of acute heart failure, are associated with increased risk of cardiovascular disease (CVD) in the general population. However, there is little information on the potential role of NT-proBNP as a biomar...

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Detalles Bibliográficos
Autores principales: Gruden, Gabriella, Barutta, Federica, Chaturvedi, Nish, Schalkwijk, Casper, Stehouwer, Coen D., Pinach, Silvia, Manzo, Maria, Loiacono, Maria, Tricarico, Marinella, Mengozzi, Giulio, Witte, Daniel R., Fuller, John H., Perin, Paolo Cavallo, Bruno, Graziella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425012/
https://www.ncbi.nlm.nih.gov/pubmed/22699286
http://dx.doi.org/10.2337/dc12-0089
Descripción
Sumario:OBJECTIVE: Circulating levels of NH(2)-terminal probrain natriuretic peptide (NT-proBNP), a marker of acute heart failure, are associated with increased risk of cardiovascular disease (CVD) in the general population. However, there is little information on the potential role of NT-proBNP as a biomarker of vascular complications in type 1 diabetic patients. We investigated whether serum NT-proBNP levels were associated with micro- and macrovascular disease in type 1 diabetic subjects. RESEARCH DESIGN AND METHODS: A cross-sectional nested case-control study from the EURODIAB Prospective Complications Study of 507 type 1 diabetic patients was performed. Case subjects (n = 345) were defined as those with one or more complications of diabetes; control subjects (n = 162) were those with no evidence of any complication. We measured NT-proBNP levels by a two-site sandwich electrochemiluminescence immunoassay and investigated their associations with complications. RESULTS: Mean NT-proBNP levels were significantly higher in case than in control subjects. In logistic regression analyses, NT-proBNP values >26.46 pg/mL were independently associated with a 2.56-fold increased risk of all complications. Odds ratios of CVD (3.95 [95% CI 1.26–12.35]), nephropathy (4.38 [1.30–14.76]), and distal symmetrical polyneuropathy (4.32 [1.41–13.23]) were significantly increased in patients with NT-proBNP values in the highest quartile (>84.71 pg/mL), independently of renal function and known risk factors. These associations were no longer significant after inclusion of TNF-α into the model. CONCLUSIONS: In this large cohort of type 1 diabetic subjects, we found an association between NT-proBNP and diabetic micro- and macrovascular complications. Our results suggest that the inflammatory cytokine TNF-α may be involved in this association.