Relation of B-Type Natriuretic Peptide Levels to Body Mass Index After Comprehensive Lifestyle Changes
Cross-sectional studies have reported inverse associations of B-type natriuretic peptide (BNP) with the body mass index (BMI). We evaluated whether changes in the BMI are associated with changes in BNP. A nested prospective cohort study of a lifestyle intervention (low-fat, whole-foods diet, exercis...
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| Veröffentlicht in: | The American journal of cardiology 2010-06, Vol.105 (11), p.1570-1576 |
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| creator | Chainani-Wu, Nita, DMD, MS, PhD Weidner, Gerdi, PhD Purnell, Daniel M., BA Frenda, Steven, BA Merritt-Worden, Terri, MS Kemp, Colleen, MSN, RN Kersh, Edward, MD Ornish, Dean, MD |
| description | Cross-sectional studies have reported inverse associations of B-type natriuretic peptide (BNP) with the body mass index (BMI). We evaluated whether changes in the BMI are associated with changes in BNP. A nested prospective cohort study of a lifestyle intervention (low-fat, whole-foods diet, exercise, stress management, and social support) was conducted. BNP, BMI, and other biomarkers were measured at baseline and 3 months. A total of 131 subjects, 56 with coronary heart disease (CHD) and 75 at high risk, with ≥3 CHD risk factors and/or diabetes mellitus, were enrolled. At 3 months, the mean BMI had decreased (34.4 to 31.7 kg/m2 , p |
| doi_str_mv | 10.1016/j.amjcard.2010.01.016 |
| format | Article |
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We evaluated whether changes in the BMI are associated with changes in BNP. A nested prospective cohort study of a lifestyle intervention (low-fat, whole-foods diet, exercise, stress management, and social support) was conducted. BNP, BMI, and other biomarkers were measured at baseline and 3 months. A total of 131 subjects, 56 with coronary heart disease (CHD) and 75 at high risk, with ≥3 CHD risk factors and/or diabetes mellitus, were enrolled. At 3 months, the mean BMI had decreased (34.4 to 31.7 kg/m2 , p <0.001), BNP had increased (median 18 to 28 pg/ml, p <0.001), and low-density lipoprotein, C-reactive protein, apolipoprotein B (all p <0.002), and angina frequency (p = 0.017) and severity (p = 0.052) had decreased. The subjects' physical limitations had decreased and their physical functioning had improved (all p <0.001). The percentage of change in BNP was inversely associated with the percentage of change in insulin (r = −0.339, p = 0.005, n = 63 nondiabetics). It was also inversely associated with the percentage of change in BMI (r = −0.28, p = 0.002, n = 116), and this association remained significant (p = 0.029) in multiple regression analyses controlling for age, gender, CHD, diabetes mellitus, percentage of change in lifestyle index, and β-blocker use. The metabolic changes related to adipose tissue lipolysis could explain these findings. In conclusion, BNP increased in subjects experiencing weight loss while following a lifestyle intervention, and angina pectoris, physical limitations, and other CHD risk factors decreased. Therefore, in this context, increasing BNP might not indicate worsening disease or a worsening prognosis. Thus, the proposed use of BNP in monitoring disease progression should take into account changes in the BMI during the same period.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.01.016</identifier><identifier>PMID: 20494664</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Biomarkers - blood ; Body Mass Index ; California ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cohort Studies ; Coronary Disease - blood ; Coronary Disease - diagnosis ; Diabetes Complications - blood ; Female ; Humans ; Life Style ; Lifestyles ; Male ; Medical sciences ; Metabolism ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Pennsylvania ; Peptides ; Prognosis ; Prospective Studies ; Regression Analysis ; Risk Factors ; Severity of Illness Index ; West Virginia</subject><ispartof>The American journal of cardiology, 2010-06, Vol.105 (11), p.1570-1576</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Sequoia S.A. Jun 1, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-d785f4379cb2eebf6ef101e7efb6fb8a31275e696a701383ae4a63566ebb0bfc3</citedby><cites>FETCH-LOGICAL-c542t-d785f4379cb2eebf6ef101e7efb6fb8a31275e696a701383ae4a63566ebb0bfc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2010.01.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22884507$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20494664$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chainani-Wu, Nita, DMD, MS, PhD</creatorcontrib><creatorcontrib>Weidner, Gerdi, PhD</creatorcontrib><creatorcontrib>Purnell, Daniel M., BA</creatorcontrib><creatorcontrib>Frenda, Steven, BA</creatorcontrib><creatorcontrib>Merritt-Worden, Terri, MS</creatorcontrib><creatorcontrib>Kemp, Colleen, MSN, RN</creatorcontrib><creatorcontrib>Kersh, Edward, MD</creatorcontrib><creatorcontrib>Ornish, Dean, MD</creatorcontrib><title>Relation of B-Type Natriuretic Peptide Levels to Body Mass Index After Comprehensive Lifestyle Changes</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Cross-sectional studies have reported inverse associations of B-type natriuretic peptide (BNP) with the body mass index (BMI). We evaluated whether changes in the BMI are associated with changes in BNP. A nested prospective cohort study of a lifestyle intervention (low-fat, whole-foods diet, exercise, stress management, and social support) was conducted. BNP, BMI, and other biomarkers were measured at baseline and 3 months. A total of 131 subjects, 56 with coronary heart disease (CHD) and 75 at high risk, with ≥3 CHD risk factors and/or diabetes mellitus, were enrolled. At 3 months, the mean BMI had decreased (34.4 to 31.7 kg/m2 , p <0.001), BNP had increased (median 18 to 28 pg/ml, p <0.001), and low-density lipoprotein, C-reactive protein, apolipoprotein B (all p <0.002), and angina frequency (p = 0.017) and severity (p = 0.052) had decreased. The subjects' physical limitations had decreased and their physical functioning had improved (all p <0.001). The percentage of change in BNP was inversely associated with the percentage of change in insulin (r = −0.339, p = 0.005, n = 63 nondiabetics). It was also inversely associated with the percentage of change in BMI (r = −0.28, p = 0.002, n = 116), and this association remained significant (p = 0.029) in multiple regression analyses controlling for age, gender, CHD, diabetes mellitus, percentage of change in lifestyle index, and β-blocker use. The metabolic changes related to adipose tissue lipolysis could explain these findings. In conclusion, BNP increased in subjects experiencing weight loss while following a lifestyle intervention, and angina pectoris, physical limitations, and other CHD risk factors decreased. Therefore, in this context, increasing BNP might not indicate worsening disease or a worsening prognosis. Thus, the proposed use of BNP in monitoring disease progression should take into account changes in the BMI during the same period.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Body Mass Index</subject><subject>California</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cohort Studies</subject><subject>Coronary Disease - blood</subject><subject>Coronary Disease - diagnosis</subject><subject>Diabetes Complications - blood</subject><subject>Female</subject><subject>Humans</subject><subject>Life Style</subject><subject>Lifestyles</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Pennsylvania</subject><subject>Peptides</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>West Virginia</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl2L1TAQhoMo7nH1JyhBEK96zEebtDfK7sGPheMHul6HNJ24qW1Tk_Zg_70p57jC3ggDIeGZyTszL0JPKdlSQsWrdqv71ujQbBlJb4SmEPfQhpayymhF-X20IYSwrKJ5dYYexdimK6WFeIjOGMmrXIh8g-xX6PTk_IC9xZfZ9TIC_qSn4OYAkzP4C4yTawDv4QBdxJPHl75Z8EcdI74aGviNL-wEAe98Pwa4gSG6Q6KdhTgtHeDdjR5-QHyMHljdRXhyOs_R93dvr3cfsv3n91e7i31mipxNWSPLwuZcVqZmALUVYFOzIMHWwtal5pTJAkQltCSUl1xDrgUvhIC6JrU1_By9PNYdg_81Jw2qd9FA1-kB_ByV5JySPC9IIp_fIVs_hyGJU7yQhDEhywQVR8gEH2MAq8bgeh0WRYla16BadVqDWtegCE0hUt6zU_G57qG5zfo79wS8OAE6Gt3ZoAfj4j-OlWUSKRP35sil4cPBQVDROBgMNC6AmVTj3X-lvL5TwXRucOnTn7BAvG2aqsgUUd9Wz6yWoatbCCv4H_hqvLg</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Chainani-Wu, Nita, DMD, MS, PhD</creator><creator>Weidner, Gerdi, PhD</creator><creator>Purnell, Daniel M., BA</creator><creator>Frenda, Steven, BA</creator><creator>Merritt-Worden, Terri, MS</creator><creator>Kemp, Colleen, MSN, RN</creator><creator>Kersh, Edward, MD</creator><creator>Ornish, Dean, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Relation of B-Type Natriuretic Peptide Levels to Body Mass Index After Comprehensive Lifestyle Changes</title><author>Chainani-Wu, Nita, DMD, MS, PhD ; Weidner, Gerdi, PhD ; Purnell, Daniel M., BA ; Frenda, Steven, BA ; Merritt-Worden, Terri, MS ; Kemp, Colleen, MSN, RN ; Kersh, Edward, MD ; Ornish, Dean, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-d785f4379cb2eebf6ef101e7efb6fb8a31275e696a701383ae4a63566ebb0bfc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Body Mass Index</topic><topic>California</topic><topic>Cardiology</topic><topic>Cardiology. 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We evaluated whether changes in the BMI are associated with changes in BNP. A nested prospective cohort study of a lifestyle intervention (low-fat, whole-foods diet, exercise, stress management, and social support) was conducted. BNP, BMI, and other biomarkers were measured at baseline and 3 months. A total of 131 subjects, 56 with coronary heart disease (CHD) and 75 at high risk, with ≥3 CHD risk factors and/or diabetes mellitus, were enrolled. At 3 months, the mean BMI had decreased (34.4 to 31.7 kg/m2 , p <0.001), BNP had increased (median 18 to 28 pg/ml, p <0.001), and low-density lipoprotein, C-reactive protein, apolipoprotein B (all p <0.002), and angina frequency (p = 0.017) and severity (p = 0.052) had decreased. The subjects' physical limitations had decreased and their physical functioning had improved (all p <0.001). The percentage of change in BNP was inversely associated with the percentage of change in insulin (r = −0.339, p = 0.005, n = 63 nondiabetics). It was also inversely associated with the percentage of change in BMI (r = −0.28, p = 0.002, n = 116), and this association remained significant (p = 0.029) in multiple regression analyses controlling for age, gender, CHD, diabetes mellitus, percentage of change in lifestyle index, and β-blocker use. The metabolic changes related to adipose tissue lipolysis could explain these findings. In conclusion, BNP increased in subjects experiencing weight loss while following a lifestyle intervention, and angina pectoris, physical limitations, and other CHD risk factors decreased. Therefore, in this context, increasing BNP might not indicate worsening disease or a worsening prognosis. Thus, the proposed use of BNP in monitoring disease progression should take into account changes in the BMI during the same period.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20494664</pmid><doi>10.1016/j.amjcard.2010.01.016</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Biomarkers - blood Body Mass Index California Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cohort Studies Coronary Disease - blood Coronary Disease - diagnosis Diabetes Complications - blood Female Humans Life Style Lifestyles Male Medical sciences Metabolism Middle Aged Natriuretic Peptide, Brain - blood Pennsylvania Peptides Prognosis Prospective Studies Regression Analysis Risk Factors Severity of Illness Index West Virginia |
| title | Relation of B-Type Natriuretic Peptide Levels to Body Mass Index After Comprehensive Lifestyle Changes |
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