NT-proBNP levels are inversely associated with fasting but not 2-hour glucose concentrations

Introduction Brain natriuretic peptide (BNP) is the standard diagnostic biomarker for heart failure and cardiac dysfunction. Recent studies suggested associations between BNPs and metabolic parameters, including insulin sensitivity (IS), fasting glucose (FG), and risk for type two diabetes (T2D). Purpose Our goal was to analyse the associations of NT-proBNP with parameters obtained by the oral glucose tolerance test (OGTT) in a general population sample. Methods We performed cross-sectional analyses of 3,091 individuals (1,599 women; 51.7%) using data from the population-based Study of Health in Pomerania (SHIP-TREND-0) from northern Germany. We used linear regression models to test the associations between NT-proBNP and fasting glucose (FG), insulin (FI), the homeostasis model assessment-insulin resistance index (HOMA-IR), 2-hour postload glucose (2HG), and glucose tolerance categories stratified by sex. The multivariable models were adjusted for age, body fat-free mass, body fat mass, height^2.7, systolic blood pressure, use of antihypertensive medication, smoking status, estimated glomerular filtration rate and prevalent cardiovascular disease (myocardial infarction and stroke). Results Figure 1 shows the associations of NT-proBNP levels with FG, FI, HOMA-IR and 2HG stratified by sex. NT-proBNP was inversely associated with FG, showing a nonlinear association in men but a linear one in women. In men, the inverse association with FG was stronger at lower NT-proBNP levels but weakened as NT-proBNP increased. In women, a 10 pg/mL increase in NT-proBNP was associated with a 0.006 mmol/L decline (95% CI: -0.003 to -0.009; p<0.001) in FG. We also observed inverse associations of NT-proBNP with FI and HOMA-IR in both sexes. A 10 pg/mL increase in NT-proBNP was associated with a 0.043 µU/mL (95% CI: -0.014 to -0.072; p=0.004) decrease in FI for men and a 0.082 µU/mL decrease in FI for women (-0.058 to –0.106; p<0.001), while HOMA-IR values each dropped 0.014 in men (-0.006 to -0.022; p=0.001) and 0.02 in women (-0.013 to -0.027; p<0.001), respectively. We found no associations between NT-proBNP and 2HG in men or women. Figure 2 shows the different OGTT groups and their median NT-proBNP concentrations stratified by sex. NT-proBNP levels were significantly lower in both men and women in the i-IFG group when compared to the NGT groups. In men, NT-proBNP concentrations were 5.95 pg/mL lower (95% CI: -0.03 to 11.9; p=0.051), while in women, they were 20.1 pg/mL lower (-9.2 to -31.1; p=0.001) than in the NGT group. We found no differences between the NT-proBNP concentrations of the i-IGT group, the IFG + IGT group, or the UDM group compared to the NGT group. Conclusions We found inverse associations between NT-proBNP and FG, FI and HOMA-IR for both men and women. However, there were no associations with 2HG. Participants with i-IFG had lower NT-proBNP levels than those with NGT in both men and women.