Key result
BNP markedly increases adipose tissue lipolysis ~3-fold, showing heightened sensitivity in heart failure patients.
Why the study?
Enhanced adipose tissue lipolysis contributes to myocardial lipid overload, insulin resistance, and cachexia in advanced HF. Although natriuretic peptides were recognized to stimulate lipolysis in healthy subjects, the role of BNP in lipolysis regulation in HF patients needed to be examined.
Does B-type natriuretic peptide(1-32) stimulate subcutaneous abdominal adipose tissue lipolysis in nondiabetic NYHA class III heart failure patients compared with healthy controls?
Does B-type natriuretic peptide(1-32) stimulate subcutaneous abdominal adipose tissue lipolysis in nondiabetic NYHA class III heart failure patients compared with healthy controls?
Adipose tissue responsiveness to exogenous BNP(1-32) is preserved or heightened in advanced heart failure patients despite elevated endogenous immunoreactive BNP, suggesting BNP-mediated lipolysis may contribute to excessive fatty acid mobilization, insulin resistance, and cachexia in HF.
Answers are grounded in this paper and cite their sources.
BNP1-32 lipolysis may differ in HF adipose tissue; hypothesis-generating for metabolic effects and requires prospective validation.
Objectives Our goal was to examine the role of B-type natriuretic peptide (BNP) in lipolysis regulation in heart failure (HF) patients. Background Enhanced adipose tissue lipolysis can contribute to myocardial lipid overload, insulin resistance, and cachexia in advanced HF. Natriuretic peptides were recently recognized to stimulate lipolysis in healthy subjects. Methods Ten nondiabetic HF patients (New York Heart Association functional class III, 50% nonischemic etiology) and 13 healthy subjects (control subjects) of similar age, sex, and body composition underwent a microdialysis study of subcutaneous abdominal adipose tissue. Four microdialysis probes were simultaneously perfused with 0.1 μM BNP(1-32,) 10 μM BNP(1-32), 10 μM norepinephrine (NE) or Ringer's solution. Outgoing dialysate glycerol concentration (DGC) was measured as an index of lipolysis. Results Spontaneous lipolysis was higher in HF patients compared with control subjects (DGC: 189 ± 37 μmol/l vs. 152 ± 35 μmol/l, p < 0.01). Response to NE was similar (p = 0.35) in HF patients and control subjects (DGC increase of 1.7 ± 0.2-fold vs. 1.7 ± 0.4-fold). BNP(1-32) 10 μM markedly increased lipolysis in both HF patients and control subjects (DGC increase of 2.8 ± 0.5-fold vs. 3.2 ± 0.3-fold), whereas the response to 0.1 μM BNP(1-32) was more pronounced in HF patients (p = 0.02). In HF patients, spontaneous lipolysis positively correlated with insulin resistance and the response to BNP(1-32) negatively correlated with adiposity. Conclusions BNP(1-32) exerts strong lipolytic effects in humans. Despite marked elevation of plasma immunoreactive BNP, the responsiveness of adipose tissue to BNP(1-32) is not attenuated in HF, possibly reflecting a deficiency of endogenous bioactive BNP. Lipolytic effects of BNP can contribute to excessive fatty acid mobilization in advanced HF.
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Polak et al. (2011) studied Heart failure (n=23). B-type natriuretic peptide(1-32) vs. Ringer's solution and 10 μM norepinephrine, as well as comparison between HF patients and healthy controls was evaluated on Outgoing dialysate glycerol concentration (DGC) as an index of lipolysis (p=0.02). BNP(1-32) 10 μM markedly increased adipose tissue lipolysis in HF patients and controls, with a more pronounced response to 0.1 μM BNP(1-32) in HF patients.
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