Association of Cardiac Pro-Β-Type Natriuretic Peptide Levels with Metabolic Risk Factors in Young Obese Egyptian Patients: A Focus on Normotensive vs. Hypertensive Patients

Objective: In practice, there is increasing recognition of the importance of BNP in the pathophysiology, diagnosis and prognosis of ischemic cardiac dysfunction and heart failure. The association of BNP to obesity and characteristics of the metabolic syndrome in adults and aged patients is well established, but that in pediatrics needs thorough elucidation. Methods: The aim of this study was to assess the association of plasma β-type natriuretic peptide (BNP) levels and metabolic risk factors in 40 young (average age was 13-17 years) obese normo- and hypertensive patients. This is achieved by assessment of serum levels of glucose, insulin, lipid profile as well as the proinflammatory cytokines, TNF- α, interleukin (IL)-6 and IL-23. The assessed metabolic indicators were compared with that of healthy control young subjects with normal BP (120/80 mmHg). Results: Contrasting the reported studies in adult persons, the result of the present study showed that β-type natriuretic peptide (BNP) levels are positively associated with characteristics of the metabolic syndrome; Blood pressure, BMI, HOMA index and the lipid profile in both obese groups. The hypertensive obese group exhibited an increased proinflammatory state, leading to the increased levels of serum levels of TNF-α, IL-6 and IL-23, compared to the obese normotensive group. Conclusion: Early detection of pro-BNP levels in pre-HTN stage is an effective method of prevention of cardiovascular disease. Moreover, proinflammatory mediators, TNF-α, IL-6 should be included in primary screening tests for evaluation of hypertensive patients. However, the prognostic relevance of increased pro-BNP for risk of developing cardiac insufficiency in severely obese patients needs to be further evaluated.