Horm Metab Res 2009; 41(11): 829-833
DOI: 10.1055/s-0029-1233459
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Associations Between Circulating N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) and Adiponectin Concentrations Depend on Obesity Level in Female Adolescents: Gender Dimorphic Findings

P. Pervanidou1 , A. Margeli2 , A. Akalestos2 , 3 , S. Sakka1 , C. Kanaka-Gantenbein1 , I. Papassotiriou2 , G. P. Chrousos1
  • 1The First Department of Pediatrics, Childhood and Adolescent Obesity Clinic, Athens University Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
  • 2Department of Clinical Biochemistry, “Aghia Sophia” Children's Hospital, Athens, Greece
  • 3Roche Diagnostics SA, Roche Hellas, Amaroussion, Greece
Further Information

Publication History

received 12.01.2009

accepted 15.06.2009

Publication Date:
10 August 2009 (online)

Abstract

N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) is an established biomarker for heart failure in adults, while its plasma concentrations are altered in adult obesity. Plasma adiponectin concentrations are decreased in obesity and low levels are associated with disorders with an increased cardiometabolic risk. A few studies support an association between these two markers in adults with coronary heart disease. Such relations have not been investigated in children with obesity, which is the most prevalent risk factor for cardiovascular disease. Ninety-six children, 24 obese/25 normal BMI boys, and 23 obese/24 normal BMI girls, aged 10–16, were studied. Plasma NT-proBNP was measured using electrochemiluminescence, and adiponectin and other metabolic risk factors, such as glucose, insulin, cholesterol, triglycerides (TG), HDL, and LDL using standard methodology. The findings were gender dimorphic. In overweight and obese females (mean BMI z-score: 2.65±1.69), plasma NT-proBNP concentrations correlated significantly with adiponectin levels (r=0.4, r2=0.05, p=0.013), while in those with obesity defined as BMI z-score >2.5 (mean BMI z-score: 3.67±1.08, n=20) this association was stronger (r=0.6, r2=0.22, p=0.005). Adiponectin also correlated significantly with BMI z-scores, TG, HDL, and insulin levels. In boys, there was no correlation between NT-proBNP and adiponectin. NT-proBNP correlated significantly with HDL, while adiponectin correlated with TG, fasting insulin, and the Homeostasis Assessment Model (HOMA) Index. The positive association between NT-proBNP and adiponectin depends on the severity of obesity and is gender dimorphic. This positive correlation in females might be a potential protective mechanism against atherosclerosis in later life.

References

  • 1 Pervanidou P, Chrousos GP. Brain Natriuretic Peptide (BNP), In: Fink G (Editor-in-Chief): Encyclopedia of Stress. Oxford: Academic Press, 2nd ed 2007 Vol. 1: 357-360
  • 2 Suttner SW, Boldt J. Natriuretic peptide system: physiology and clinical utility.  Curr Opin Crit Care. 2004;  10 336-341
  • 3 Hall C. NT-ProBNP: the mechanism behind the marker.  J Card Fail. 2005;  11 ((5 Suppl)) S81-S83
  • 4 Maeda K, Tsutamoto T, Wada A, Hisanaga T, Kinoshita M. Plasma brain natriuretic peptide as a biochemical marker of high left ventricular end-diastolic pressure in patients with symptomatic left ventricular dysfunction.  Am Heart J. 1998;  135 825-832
  • 5 Worster A, Balion CM, Hill SA, Santaguida P, Ismaila A, McKelvie R, Reichert SM, McQueen MJ, Booker L, Raina PS. Diagnostic accuracy of BNP and NT-proBNP in patients presenting to acute care settings with dyspnea: A systematic review.  Clin Biochem. 2008;  41 ((4–5)) 250-259
  • 6 McCord J, Mundy BJ, Hudson MP, Maisel AS, Hollander JE, Abraham WT, Steg PG, Omland T, Knudsen CW, Sandberg KR, McCullough PA. for the Breathing Not Properly Multinational Study Investigators . Relationship between obesity and B-type natriuretic peptide levels.  Arch Intern Med. 2004;  164 2247-2252
  • 7 Iwanaga Y, Kihara Y, Niizuma S, Noguchi T, Nonogi H, Kita T, Goto Y. BNP in overweight and obese patients with heart failure: an analysis based on the BNP-LV diastolic wall stress relationship.  J Card Fail. 2007;  13 663-667
  • 8 Taylor JA, Christenson RH, Rao K, Jorge M, Gottlieb SS. B-type natriuretic peptide and N-terminal pro B-type natriuretic peptide are depressed in obesity despite higher left ventricular end diastolic pressures.  Am Heart J. 2006;  152 1071-1076
  • 9 Mir TS, Laux R, Hellwege HH, Liedke B, Heinze C, von Buelow H, Läer S, Weil J. Plasma Concentrations of N-Terminal Brain Natriuretic Peptide in Healthy Children, Adolescents and Young Adults: effect of Age and Gender.  Pediatrics. 2003;  112 896-899
  • 10 Pervanidou P, Akalestos A, Sakka S, Kanaka-Gantenbein C, Papassotiriou I, Chrousos GP. Gender Dimorphic Associations between N-terminal pro-Brain Natriuretic Peptide, Body Mass Index and Blood Pressure in Children and Adolescents.  Hormone Research. 2009;  in press
  • 11 Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T, Miyaoka K, Kuriyama H, Nishida M, Yamashita S, Okubo K, Matsubara K, Muraguchi M, Ohmoto Y, Funahashi T, Matsuzawa Y. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity.  Biochem Biophys Res Commun. 1999;  257 79-83
  • 12 Goyenechea E, Collins LJ, Parra D, Abete I, Crujeiras AB, O’Dell SD, Martínez JA. The – 11391 G/A polymorphism of the adiponectin gene promoter is associated with metabolic syndrome traits and the outcome of an energy-restricted diet in obese subjects.  Horm Metab Res. 2009;  41 55-61
  • 13 Owecki M, Miczke A, Pupek-Musialik D, Bryl W, Cymerys M, Nikisch E, Sowiński J. Circulating serum adiponectin concentrations do not differ between obese and non-obese Caucasians and are unrelated to insulin sensitivity.  Horm Metab Res. 2007;  39 25-30
  • 14 Kamari Y, Grossman E, Oron-Herman M, Peleg E, Shabtay Z, Shamiss A, Sharabi Y. Metabolic stress with a high carbohydrate diet increases adiponectin levels.  Horm Metab Res. 2007;  39 384-388
  • 15 Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H, Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M, Ohmoto Y, Nakamura T, Yamashita S, Hanafusa T, Matsuzawa Y. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients.  Arterioscler Thromb Vasc Biol. 2000;  20 1595-1599
  • 16 Koebnick C, Roberts CK, Shaibi GQ, Kelly LA, Lane CJ, Toledo-Corral CM, Davis JN, Ventura EE, Alexander K, Weigensberg MJ, Goran MI. Adiponectin and leptin are independently associated with insulin sensitivity, but not with insulin secretion or beta-cell function in overweight Hispanic adolescents.  Horm Metab Res. 2008;  40 708-712
  • 17 Kumada M, Kihara S, Sumitsuji S, Kawamoto T, Matsumoto S, Ouchi N, Arita Y, Okamoto Y, Shimomura I, Hiraoka H, Nakamura T, Funahashi T, Matsuzawa Y. O Osaka CAD Study Group. Coronary artery disease. Association of hypoadiponectinemia with coronary artery disease in men.  Arterioscler Thromb Vasc Biol. 2003;  23 85-89
  • 18 Iwashima Y, Katsuya T, Ishikawa K, Ouchi N, Ohishi M, Sugimoto K, Fu Y, Motone M, Yamamoto K, Matsuo A, Ohashi K, Kihara S, Funahashi T, Rakugi H, Matsuzawa Y, Ogihara T. Hypoadiponectinemia is an independent risk factor for hypertension.  Hypertension. 2004;  43 1318-1323
  • 19 Ouchi N, Kihara S, Funahashi T, Matsuzawa Y, Walsh K. Obesity, adiponectin and vascular inflammatory disease.  Curr Opin Lipidol. 2003;  14 561-566
  • 20 Dieplinger B, Poelz W, Haltmayer M, Mueller T. Association of adiponectin and amino terminal proBNP in peripheral arterial disease.  Clin Chim Acta. 2007;  377 192-197
  • 21 von Eynatten M, Hamann A, Twardella D, Nawroth PP, Brenner H, Rothenbacher D. Relationship of adiponectin with markers of systemic inflammation, atherogenic dyslipidemia, and heart failure in patients with coronary heart disease.  Clin Chem. 2006;  52 853-859
  • 22 Chiotis D, Krikos X, Tsiftis G, Hatzisymeaon M, Maniati-Christidi M, Dacou-Voutetakis A. Body mass index and prevalence of obesity in subjects of Hellenic origin aged 0–18 years, living in the Athens area.  Ann Clin Pediatr Univ Atheniensis. 2004;  51 139-154
  • 23 National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents . The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in Children and Adolescents.  Pediatrics. 2004;  114 555-576
  • 24 Tanner JM. Growth at adolescence. 2nd edn. Oxford: Blackwell Scientific Publications 1962
  • 25 Olsen MH, Hansen TW, Christensen MK, Gustafsson F, Rasmussen S, Wachtell K, Borch-Johnsen K, Ibsen H, Jørgensen T, Hildebrandt P. N-terminal pro brain natriuretic peptide is inversely related to metabolic cardiovascular risk factors and the metabolic syndrome.  Hypertension. 2005;  46 660-666
  • 26 Kistorp C, Faber J, Galatius S, Gustafsson F, Frystyk J, Flyvbjerg A, Hildebrandt P. Plasma adiponectin, body mass index, and mortality in patients with chronic heart failure.  Circulation. 2005;  112 1756-1762
  • 27 McCullough PA, Omland T, Maisel AS. B-type natriuretic peptides: a diagnostic breakthrough for clinicians.  Rev Cardiovasc Med. 2003;  4 72-80
  • 28 Hall C. Essential biochemistry and physiology of (NT-pro)BNP.  Eur J Heart Fail. 2004;  6 257-260
  • 29 Sengenes C, Stich V, Berlan M, Hejnova J, Lafontan M, Pariskova Z, Galitzky J. Increased lipolysis in adipose tissue and lipid mobilization to natriuretic peptides during low-calorie diet in obese women.  Int J Obes Relat Metab Disord. 2002;  26 24-32

Correspondence

P. PervanidouMD 

First Department of Pediatrics

Athens University Medical School

“Aghia Sophia” Children's Hospital

Thivon & Levadias Street

Athens

Greece

Phone: +30/210/746 74 57

Fax: +30/210/652 50 13

Email: ppervanid@med.uoa.gr

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