z_bumbi
2011-08-30, 19:15
Ursäkta svengelskan i rubriken men vad heter "Cardiac Natriuretic Peptides" på svenska?
Clin Endocrinol Metab. 2011 Aug 17. [Epub ahead of print]
Cardiac Natriuretic Peptides, Obesity, and Insulin Resistance: Evidence from Two Community-Based Studies.
Khan AM, Cheng S, Magnusson M, Larson MG, Newton-Cheh C, McCabe EL, Coviello AD, Florez JC, Fox CS, Levy D, Robins SJ, Arora P, Bhasin S, Lam CS, Vasan RS, Melander O, Wang TJ.
Source
Cardiology Division (A.M.K., S.C., C.N.-C., E.L.M., P.A., T.J.W.), Massachusetts General Hospital, Center for Human Genetic Research (C.N.-C., J.C.F.) and Diabetes Research Center (Diabetes Unit) (J.C.F.), Massachusetts General Hospital (J.C.F.), Harvard Medical School, Boston, Massachusetts 02114; Cardiovascular Medicine Division (A.M.K.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104; Framingham Heart Study (S.C., M.G.L., C.N.-C., E.L.M., C.S.F., S.J.R., R.S.V., D.L., T.J.W.), Framingham, Massachusetts 01702; Divisions of Cardiovascular Medicine (S.C.) and Endocrinology, Metabolism, and Diabetes (C.S.F.), Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Department of Clinical Sciences (M.M., O.M.), Lund University, SE-200 41Malmö, Sweden; Department of Cardiology, Skånes University Hospital, Lund University, SE-205 02 Malmö, Sweden; Department of Mathematics and Statistics (M.G.L.), Boston University, Boston, Massachusetts 02215; Program in Medical and Population Genetics (C.N.-C., J.C.F.), Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts 02142; Center for Population Studies (C.S.F., D.L.), National Heart, Lung, and Blood Institute, Bethesda, Maryland 20824; Division of Preventive Medicine, Department of Medicine (A.D.C., R.S.V.), and Division of Endocrinology, Diabetes, and Nutrition (S.B.), Boston University School of Medicine, Boston, Massachusetts 02118; and National University Health System (C.S.P.L.), Singapore 119228.
Abstract
Background: The natriuretic peptides play an important role in salt homeostasis and blood pressure regulation. It has been suggested that obesity promotes a relative natriuretic peptide deficiency, but this has been a variable finding in prior studies and the cause is unknown. Aim: The aim of this study was to examine the association between obesity and natriuretic peptide levels and evaluate the role of hyperinsulinemia and testosterone as mediators of this interaction. Methods: We studied 7770 individuals from the Framingham Heart Study (n = 3833, 54% women) and the Malmö Diet and Cancer study (n = 3918, 60% women). We examined the relation of plasma N-terminal pro-B-type natriuretic peptide levels (N-BNP) with obesity, insulin resistance, and various metabolic subtypes. Results: Obesity was associated with 6-20% lower levels of N-BNP (P < 0.001 in Framingham, P = 0.001 in Malmö), whereas insulin resistance was associated with 10-30% lower levels of N-BNP (P < 0.001 in both cohorts). Individuals with obesity who were insulin sensitive had only modest reductions in N-BNP compared with nonobese, insulin-sensitive individuals. On the other hand, individuals who were nonobese but insulin resistant had 26% lower N-BNP in Framingham (P < 0.001) and 10% lower N-BNP in Malmö (P < 0.001), compared with nonobese and insulin-sensitive individuals. Adjustment for serum-free testosterone did not alter these associations. Conclusions: In both nonobese and obese individuals, insulin resistance is associated with lower natriuretic peptide levels. The relative natriuretic peptide deficiency seen in obesity could be partly attributable to insulin resistance, and could be one mechanism by which insulin resistance promotes hypertension.
Clin Endocrinol Metab. 2011 Aug 17. [Epub ahead of print]
Cardiac Natriuretic Peptides, Obesity, and Insulin Resistance: Evidence from Two Community-Based Studies.
Khan AM, Cheng S, Magnusson M, Larson MG, Newton-Cheh C, McCabe EL, Coviello AD, Florez JC, Fox CS, Levy D, Robins SJ, Arora P, Bhasin S, Lam CS, Vasan RS, Melander O, Wang TJ.
Source
Cardiology Division (A.M.K., S.C., C.N.-C., E.L.M., P.A., T.J.W.), Massachusetts General Hospital, Center for Human Genetic Research (C.N.-C., J.C.F.) and Diabetes Research Center (Diabetes Unit) (J.C.F.), Massachusetts General Hospital (J.C.F.), Harvard Medical School, Boston, Massachusetts 02114; Cardiovascular Medicine Division (A.M.K.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104; Framingham Heart Study (S.C., M.G.L., C.N.-C., E.L.M., C.S.F., S.J.R., R.S.V., D.L., T.J.W.), Framingham, Massachusetts 01702; Divisions of Cardiovascular Medicine (S.C.) and Endocrinology, Metabolism, and Diabetes (C.S.F.), Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Department of Clinical Sciences (M.M., O.M.), Lund University, SE-200 41Malmö, Sweden; Department of Cardiology, Skånes University Hospital, Lund University, SE-205 02 Malmö, Sweden; Department of Mathematics and Statistics (M.G.L.), Boston University, Boston, Massachusetts 02215; Program in Medical and Population Genetics (C.N.-C., J.C.F.), Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts 02142; Center for Population Studies (C.S.F., D.L.), National Heart, Lung, and Blood Institute, Bethesda, Maryland 20824; Division of Preventive Medicine, Department of Medicine (A.D.C., R.S.V.), and Division of Endocrinology, Diabetes, and Nutrition (S.B.), Boston University School of Medicine, Boston, Massachusetts 02118; and National University Health System (C.S.P.L.), Singapore 119228.
Abstract
Background: The natriuretic peptides play an important role in salt homeostasis and blood pressure regulation. It has been suggested that obesity promotes a relative natriuretic peptide deficiency, but this has been a variable finding in prior studies and the cause is unknown. Aim: The aim of this study was to examine the association between obesity and natriuretic peptide levels and evaluate the role of hyperinsulinemia and testosterone as mediators of this interaction. Methods: We studied 7770 individuals from the Framingham Heart Study (n = 3833, 54% women) and the Malmö Diet and Cancer study (n = 3918, 60% women). We examined the relation of plasma N-terminal pro-B-type natriuretic peptide levels (N-BNP) with obesity, insulin resistance, and various metabolic subtypes. Results: Obesity was associated with 6-20% lower levels of N-BNP (P < 0.001 in Framingham, P = 0.001 in Malmö), whereas insulin resistance was associated with 10-30% lower levels of N-BNP (P < 0.001 in both cohorts). Individuals with obesity who were insulin sensitive had only modest reductions in N-BNP compared with nonobese, insulin-sensitive individuals. On the other hand, individuals who were nonobese but insulin resistant had 26% lower N-BNP in Framingham (P < 0.001) and 10% lower N-BNP in Malmö (P < 0.001), compared with nonobese and insulin-sensitive individuals. Adjustment for serum-free testosterone did not alter these associations. Conclusions: In both nonobese and obese individuals, insulin resistance is associated with lower natriuretic peptide levels. The relative natriuretic peptide deficiency seen in obesity could be partly attributable to insulin resistance, and could be one mechanism by which insulin resistance promotes hypertension.