Association between sleep-disordered breathing, aminoterminal pro-brain natriuretic peptide (NT-proBNP) levels and insulin resistance in morbidly obese young women
Por:
Ybarra, J, Planas, F, Navarro-Lopez, F, Pujadas, S, Pujadas, J, Jurado, J, Pou, JM
Publicada:
1 mar 2009
Resumen:
Objective: Sleep-disordered breathing (SDB) is often encountered in morbid obesity (MO) in conjunction with insulin resistance (IR) and several cardio-vascular risk factors. Aminoterminal pro-brain natriuretic peptide (NT-proBNP) is a promising marker for left ventricular dysfunction (LVD) in MO. The aim of this study was to look for possible correlations between SDB, IR, heart structure and function indexes and NT-proBNP levels in MO female subjects.
Materials and methods: Cross-sectional study involving 110 MO (44.5 +/- 0.7 kg m(-2)) apparently healthy, young (37.8 +/- 1.0 y.o.) female patients. NT-proBNP was measured using an ELISA kit (Roche). Echo-cardiograms were performed to quantify left ventricular ejection fraction values (LVEF), cardiac output (CO), left ventricular mass (LVM), left atria size (LA) and left ventricular filling pressures (the E/Em ratio). The Berlin Questionnaire (BQ) was used to assess the risk of SDB. IR and sensitivity were assessed using the HOMA index and adiponectin measurements, respectively.
Results. All patients had a normal LVEF (>50%). Hypertension and Type 2 diabetes mellitus prevalences were 34.5 and 4.5% (respectively). Log-transformed NT-proBNP levels correlated with BQ categories (P<0.0005), creatinine (P<0.001), age (P<0.05), LVM (P<0.001), CO (P<0.001), LA (P<0.0005) and E/Em (P<0.01). NT-proBNP levels, LVD and LVM increased significantly along with BQ scores (P<0.0001). Stepwise multiple regression analysis identified BQ and log-transformed HOMA as independent variables predicting as much as 48.0% of log-transformed NT-proBNP's variability (dependent variable).
Conclusions: NT-proBNP levels are independently predicted by SDB and IR in asymptomatic MO women, Additionally, SDB worsens along with LVH and diastolic dysfunction. Larger prospective studies are warranted. (C) 2008 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Filiaciones:
Ybarra, J:
Ctr Med Teknon, Inst Cardiol & Med Avanzada, Barcelona 08021, Spain
UAB, Hosp St Pau, Serv Endocrinol & Nutr, Barcelona, Spain
Planas, F:
Ctr Med Teknon, Inst Cardiol & Med Avanzada, Barcelona 08021, Spain
Navarro-Lopez, F:
Ctr Med Teknon, Inst Cardiol & Med Avanzada, Barcelona 08021, Spain
Pujadas, S:
Ctr Med Teknon, Inst Cardiol & Med Avanzada, Barcelona 08021, Spain
Pujadas, J:
Ctr Med Teknon, Inst Cardiol & Med Avanzada, Barcelona 08021, Spain
Jurado, J:
Catalan Inst Hlth, Primary Care Res Inst IDIAP, Olot Girona, Spain
Pou, JM:
UAB, Hosp St Pau, Serv Endocrinol & Nutr, Barcelona, Spain
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