Key Points
- To assess how diabetes impacts the inverse association between body mass index and plasma NT-proBNP levels in patients with preserved systolic function.
- Evaluated 933 patients (N=933; 733 non-diabetic and 200 diabetic) presenting with chest pain or dyspnea, normal systolic heart function, and serum creatinine <2.0 mg/dL undergoing cardiac catheterization.
- Measured baseline plasma NT-proBNP, calculated body mass index (BMI), and performed transthoracic echocardiography to assess left ventricular geometry and mitral E/Ea.
- In non-diabetic patients, mean plasma NT-proBNP showed a significant inverse correlation with BMI: non-obese (856.39±237.3 pg/mL), overweight (601.69±159.6 pg/mL), and obese (289.62±164.9 pg/mL; p<0.0001).
- In diabetic patients, the correlation between BMI and NT-proBNP was not statistically significant (r=-0.21, p=0.19), and NT-proBNP did not correlate with mitral E/Ea in obese diabetics (r=0.14, p=0.56).
- Left ventricular mass index correlated positively with NT-proBNP across all BMI categories (r=0.61, p<0.001), with the highest biomarker levels observed in patients with concentric cardiac hypertrophy.
Structured PICO
Does diabetes influence the inverse relationship between body mass index and NT-proBNP levels in patients with normal systolic function?
PPopulation933 patients with chest pain and/or dyspnea undergoing cardiac catheterization, with creatinine levels <2.0 mg/dL and normal systolic heart function (LVEF ≥50%). 733 non-diabetic and 200 diabetic patients.
OOutcomeCorrelation between plasma NT-proBNP levels and body mass index (BMI)surrogate
The expected inverse relationship between BMI and NT-proBNP levels is blunted in patients with diabetes, suggesting that factors other than cardiac status affect NT-proBNP concentrations in obese diabetic patients.
Limitations
- Cross-sectional study design
- Study population was not homogenous
- Patients with renal insufficiency were excluded