Brain natriuretic peptide and insulin resistance in older adults

F. Kim, M. L. Biggs, Jorge Kizer, Erika F. Brutsaert, C. de Filippi, A. B. Newman, R. A. Kronmal, R. P. Tracy, J. S. Gottdiener, L. Djoussé, I. H. de Boer, B. M. Psaty, D. S. Siscovick, K. J. Mukamal

Research output: Contribution to journalArticle

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Abstract

Aims: Higher levels of brain natriuretic peptide (BNP) have been associated with a decreased risk of diabetes in adults, but whether BNP is related to insulin resistance in older adults has not been established. Methods: N-terminal of the pro hormone brain natriuretic peptide (NT-pro BNP) was measured among Cardiovascular Health Study participants at the 1989-1990, 1992-1993 and 1996-1997 examinations. We calculated measures of insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), Gutt index, Matsuda index] from fasting and 2-h concentrations of glucose and insulin among 3318 individuals with at least one measure of NT-proBNP and free of heart failure, coronary heart disease and chronic kidney disease, and not taking diabetes medication. We used generalized estimating equations to assess the cross-sectional association of NT-proBNP with measures of insulin resistance. Instrumental variable analysis with an allele score derived from nine genetic variants (single nucleotide polymorphisms) within or near the NPPA and NPPB loci was used to estimate an un-confounded association of NT-proBNP levels on insulin resistance. Results: Lower NT-proBNP levels were associated with higher insulin resistance even after adjustment for BMI, waist circumference and other risk factors (P <0.001 for all four indices). Although the genetic score was strongly related to measured NT-proBNP levels amongst European Americans (F statistic = 71.08), we observed no association of genetically determined NT-proBNP with insulin resistance (P = 0.38; P = 0.01 for comparison with the association of measured levels of NT-proBNP). Conclusions: In older adults, lower NT-proBNP is associated with higher insulin resistance, even after adjustment for traditional risk factors. Because related genetic variants were not associated with insulin resistance, the causal nature of this association will require future study.

Original languageEnglish (US)
JournalDiabetic Medicine
DOIs
StateAccepted/In press - 2016

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Brain Natriuretic Peptide
Insulin Resistance
pro-brain natriuretic peptide (1-76)
Waist Circumference
Chronic Renal Insufficiency
Single Nucleotide Polymorphism
Coronary Disease
Fasting
Heart Failure
Alleles
Hormones
Insulin
Glucose

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Kim, F., Biggs, M. L., Kizer, J., Brutsaert, E. F., de Filippi, C., Newman, A. B., ... Mukamal, K. J. (Accepted/In press). Brain natriuretic peptide and insulin resistance in older adults. Diabetic Medicine. https://doi.org/10.1111/dme.13139

Brain natriuretic peptide and insulin resistance in older adults. / Kim, F.; Biggs, M. L.; Kizer, Jorge; Brutsaert, Erika F.; de Filippi, C.; Newman, A. B.; Kronmal, R. A.; Tracy, R. P.; Gottdiener, J. S.; Djoussé, L.; de Boer, I. H.; Psaty, B. M.; Siscovick, D. S.; Mukamal, K. J.

In: Diabetic Medicine, 2016.

Research output: Contribution to journalArticle

Kim, F, Biggs, ML, Kizer, J, Brutsaert, EF, de Filippi, C, Newman, AB, Kronmal, RA, Tracy, RP, Gottdiener, JS, Djoussé, L, de Boer, IH, Psaty, BM, Siscovick, DS & Mukamal, KJ 2016, 'Brain natriuretic peptide and insulin resistance in older adults', Diabetic Medicine. https://doi.org/10.1111/dme.13139
Kim F, Biggs ML, Kizer J, Brutsaert EF, de Filippi C, Newman AB et al. Brain natriuretic peptide and insulin resistance in older adults. Diabetic Medicine. 2016. https://doi.org/10.1111/dme.13139
Kim, F. ; Biggs, M. L. ; Kizer, Jorge ; Brutsaert, Erika F. ; de Filippi, C. ; Newman, A. B. ; Kronmal, R. A. ; Tracy, R. P. ; Gottdiener, J. S. ; Djoussé, L. ; de Boer, I. H. ; Psaty, B. M. ; Siscovick, D. S. ; Mukamal, K. J. / Brain natriuretic peptide and insulin resistance in older adults. In: Diabetic Medicine. 2016.
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AU - Kim, F.

AU - Biggs, M. L.

AU - Kizer, Jorge

AU - Brutsaert, Erika F.

AU - de Filippi, C.

AU - Newman, A. B.

AU - Kronmal, R. A.

AU - Tracy, R. P.

AU - Gottdiener, J. S.

AU - Djoussé, L.

AU - de Boer, I. H.

AU - Psaty, B. M.

AU - Siscovick, D. S.

AU - Mukamal, K. J.

PY - 2016

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N2 - Aims: Higher levels of brain natriuretic peptide (BNP) have been associated with a decreased risk of diabetes in adults, but whether BNP is related to insulin resistance in older adults has not been established. Methods: N-terminal of the pro hormone brain natriuretic peptide (NT-pro BNP) was measured among Cardiovascular Health Study participants at the 1989-1990, 1992-1993 and 1996-1997 examinations. We calculated measures of insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), Gutt index, Matsuda index] from fasting and 2-h concentrations of glucose and insulin among 3318 individuals with at least one measure of NT-proBNP and free of heart failure, coronary heart disease and chronic kidney disease, and not taking diabetes medication. We used generalized estimating equations to assess the cross-sectional association of NT-proBNP with measures of insulin resistance. Instrumental variable analysis with an allele score derived from nine genetic variants (single nucleotide polymorphisms) within or near the NPPA and NPPB loci was used to estimate an un-confounded association of NT-proBNP levels on insulin resistance. Results: Lower NT-proBNP levels were associated with higher insulin resistance even after adjustment for BMI, waist circumference and other risk factors (P <0.001 for all four indices). Although the genetic score was strongly related to measured NT-proBNP levels amongst European Americans (F statistic = 71.08), we observed no association of genetically determined NT-proBNP with insulin resistance (P = 0.38; P = 0.01 for comparison with the association of measured levels of NT-proBNP). Conclusions: In older adults, lower NT-proBNP is associated with higher insulin resistance, even after adjustment for traditional risk factors. Because related genetic variants were not associated with insulin resistance, the causal nature of this association will require future study.

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