Key result
Low reactivity of B-type natriuretic peptide was a significant independent risk factor for ischemic heart disease (OR 0.364 for LogBNP), whereas body mass index itself was not directly associated.
Why the study?
Does obesity and low reactivity of B-type natriuretic peptide (BNP) associate with ischemic heart disease in Japanese patients?
Cross-Sectional (n=1,252)
Yes
Does obesity and low reactivity of B-type natriuretic peptide (BNP) associate with ischemic heart disease in Japanese patients?
Odds Ratio: 0.364 (95% CI 0.275–0.481)
p-value: p=<0.01
Obesity per se is not a strong independent risk factor for ischemic heart disease in Japanese patients, but it acts through obesity-triggered risk factors, notably including the low reactivity of B-type natriuretic peptide.
Obesity alone may not drive IHD risk in Japanese patients; leaves open whether targeting BNP hyporeactivity or other triggered factors improves outcomes.
BACKGROUND/OBJECTIVES: Obesity is believed to be one of the major risk factors for cardiovascular disease in Western countries. However, the effects of obesity should be continuously examined in the Japanese population because the average bodily habitus differs among countries. In this study, we collectively examined the significance of obesity and obesity-triggered risk factors including the low reactivity of B-type natriuretic peptide (BNP), for ischemic heart disease (IHD) in Japanese patients. METHODS AND RESULTS: The study patients consisted of 1252 subjects (IHD: n = 970; non-IHD: n = 282). Multiple logistic regression analysis revealed that dyslipidemia, hypertension, diabetes, and the low reactivity of BNP were significant risk factors for IHD, but body mass index (BMI) was not. A theoretical path model was proposed by positioning BMI at the top of the hierarchical model. Exploratory factor analysis revealed that BMI did not play a causative role in IHD (P = NS). BMI was causatively linked to other risk factors (P<0.001 for hypertension; P<0.001 for dyslipidemia; P<0.001 for HbA1c; P<0.001 for LogBNP), and these factors played a causative role in IHD (P<0.001 for hypertension; P<0.001 for dyslipidemia; P<0.001 for HbA1c; P<0.001 for LogBNP). The intrinsic power of the low reactivity of BNP induced by high BMI on the promotion of IHD was fairly potent. CONCLUSION: This study demonstrated that obesity per se is not a strong risk factor for IHD in Japanese patients. However, several important risk factors triggered by obesity exhibited a causative role for IHD. The low reactivity of BNP is a substantial risk factor for IHD.
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Tsutsumi et al. (2017) conducted a cross-sectional in Ischemic heart disease (n=1,252). Low reactivity of B-type natriuretic peptide (LogBNP) vs. Higher reactivity of BNP was evaluated on Presence of ischemic heart disease (OR 0.364, 95% CI 0.275-0.481, p=<0.01). Low reactivity of B-type natriuretic peptide was a significant independent risk factor for ischemic heart disease (OR 0.364 for LogBNP), whereas body mass index itself was not directly associated.
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