Key result
Higher baseline BNP is linked to increased diabetic nephropathy progression, CV events, and death.
Why the study?
The relationship between brain natriuretic peptide levels and the prognosis of diabetic nephropathy remained to be clarified.
Does the brain natriuretic peptide (BNP) level predict the prognosis of diabetic nephropathy, cardiovascular events, and death in patients with type 2 diabetes mellitus and microalbuminuria?
Cohort (n=100)
Does the brain natriuretic peptide (BNP) level predict the prognosis of diabetic nephropathy, cardiovascular events, and death in patients with type 2 diabetes mellitus and microalbuminuria?
Elevated BNP levels can predict the progression of diabetic nephropathy, cardiovascular events, and death in patients with type 2 diabetes and microalbuminuria.
The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and prognosis of diabetic nephropathy. The subjects were 100 Japanese outpatients with type 2 diabetes mellitus with microalbuminuria. Associations between metabolic parameters at baseline, including BNP, and prognosis of diabetic nephropathy (progression of diabetic nephropathy, cardiovascular events, and death) were examined for 7 years. In Cox proportional hazard analysis, HbA1c, albumin-creatinine ratio (ACR) and BNP were identified as significant factors for progression of diabetic nephropathy (p=0.033, p=0.037, and p=0.044, respectively), BNP was identified as significant factor for cardiovascular events (p=0.046), and estimated glomerular filtration rate (eGFR) and BNP were identified as significant factors for death (p=0.046 and p=0.048, respectively). In Kaplan-Meier analysis, risks of progression of diabetic nephropathy, cardiovascular events, and death were significantly different between patients with a low and a high BNP level (p=0.046, p=0.002, and p=0.025, respectively). ROC curve analysis gave cutoff values for BNP of 14.9 pg/ml for progression of diabetic nephropathy, 16.3 pg/ml for cardiovascular events, and 17.6 pg/ml for death (p=0.047, p=0.035, p=0.018, respectively). In conclusion, the BNP level is associated with prognosis in diabetic nephropathy.
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Seki et al. (2018) conducted a cohort in Type 2 diabetes mellitus with microalbuminuria (n=100). Brain natriuretic peptide (BNP) level vs. Low BNP level was evaluated on Progression of diabetic nephropathy, cardiovascular events, and death (p=p=0.044, p=0.046, p=0.048). Higher baseline BNP levels were significantly associated with increased risks of diabetic nephropathy progression (p=0.046), cardiovascular events (p=0.002), and death (p=0.025).
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