Effect of various weight loss interventions on serum NT-proBNP concentration in severe obese subjects without clinical manifest heart failure

Figures

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  Figure 1. Comparison of weight loss and concomitant changes in fasting blood glucose and NT-proBNP concentration after sleeve gastrectomy, gastric bypass surgery, and a 26-week weight loss program. Left column denotes pre- and post (A) weight, (D) fasting blood glucose, and (G) NT-proBNP concentration after 26 weeks of sleeve gastrectomy follow-up. Middle column denotes pre- and post (B) weight, (E) fasting blood glucose, and (H) NT-proBNP concentration after 26 weeks of gastric bypass surgery follow-up. Right column denotes pre- and post (C) weight, (F) fasting blood glucose, and (I) NT-proBNP concentration after 13 weeks of VLCD + 13 weeks of weight maintenance. All three intervention groups were not statistically different in terms of baseline NT-proBNP concentration (p = 0.72). In panels (A–F), bars denote mean weight and error bars denote 95% CI of the mean. Statistical significance of changes in weight and fasting blood glucose from pre- to post-intervention was determined by Student’s paired t-test. Only complete and valid fasting blood glucose values were included in the analysis (sleeve gastrectomy: n = 14, gastric bypass n = 9, VLCD: n = 25). In panels G–I, bars denote median…

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  Figure 2. Definition of NT-proBNP groups based on NT-proBNP plasma concentration in cross-sectional analysis. Due to the skewed distribution of NT-proBNP values in the cross-sectional FoCus cohort, we created three groups representing (1) NT-proBNP concentration below detection limit of 25.4 pg/mL (n = 220, left bar) as well as (2) low and (3) high NT-proBNP concentration. The latter two groups were created based on the median (158.9 pg/mL) of all detectable values. Individuals with an NT-proBNP concentration above 25.4 pg/mL but below 158.9 pg/mL were assigned to the low NT-proBNP group (n = 83, middle bar), while individuals with an NT-proBNP concentration equal or above 158.9 pg/mL were assigned to the high NT-proBNP group (n = 84, right bar). Bars denote median NT-proBNP concentration and error bars denote 95% CI of the median. Y axis is formatted in log10 to account for skewed distribution of NT-proBNP values. CI; confidence interval; NT-proBNP, N-terminal pro brain natriuretic peptide.

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  Figure 3. Associations between NT-proBNP concentration and (A) body weight, (B) BMI, (C) age, and (D) systolic blood pressure. Bars denote mean and error bars denote 95% CI of the mean. P trend analyses were performed using a linear regression model with NT-proBNP group as ordinal covariate and the variable of interest as dependent variable. Definition of NT-proBNP groups is shown in Fig. 2. BMI, body mass index; CI; confidence interval; NT-proBNP, N-terminal pro brain natriuretic peptide.

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  Figure 4. Associations between NT-proBNP concentration and total energy and macronutrient intake. Association between NT-proBNP concentration and (A) energy intake, (B) carbohydrate intake, (C) fat intake, and (D) protein intake. Information about the nutritional intake was assessed by a self-reported 12-month nutritional, retrospective (food frequency) questionnaire. Bars denote mean and error bars denote 95% CI of the mean. P trend analyses were performed using a linear regression model with NT-proBNP group as ordinal covariate and the variable of interest as dependent variable. Definition of NT-proBNP groups is shown in Fig. 2. CI; confidence interval; NT-proBNP, N-terminal pro brain natriuretic peptide.

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  Figure 5. Subgroup analysis: associations between NT-proBNP concentration and fasting plasma glucose in (A) euglycemic, (B) prediabetic, and (C) diabetic individuals. Euglycemia was defined as fasting plasma glucose < 100 mg/dL, prediabetes was defined as fasting plasma glucose between 100 and 126 mg/dL, and diabetes was defined as fasting plasma glucose > 126 mg/dL. Bars denote mean and error bars denote 95% CI of the mean. P trend analyses were performed using a linear regression model with NT-proBNP group as ordinal covariate and the variable of interest as dependent variable. Statistical significance of between-group differences was calculated by unpaired t test. Definition of NT-proBNP groups is shown in Fig. 2. CI; confidence interval; NT-proBNP, N-terminal pro brain natriuretic peptide.