Higher circulating concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and midregional proatrial natriuretic peptide (MR-proANP) are associated with a lower incidence of type 2 diabetes (T2D), according to a study in Diabetes Care.
Researchers sought to investigate prospective associations of NT-proBNP and MR-proANP with incident T2D in several population-based studies from the multinational Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium and whether those associations were affected by the presence of cardiovascular disease (CVD).
A total of 45,477 participants (mean age, 51.5 years; 50.7% male; mean body mass index, 27.2 kg/m2) with NT-proBNP data were included in the analysis.
During a median follow-up of 6.5 years (interquartile range [IQR] 9.9), 1707 participants developed T2D, of whom 209 had a history of CVD at baseline. Of the 11,537 participants with MR-proANP data who were included, 857 developed T2D during a median follow-up of 13.8 years (IQR 5.0), of whom 106 had a history of CVD at baseline.
NT-proBNP and MR-proANP were inversely associated with incident T2D in the overall cohort. The hazard ratios (HRs) (95% CIs) were 0.89 (0.84; 0.94) per 1-SD increase of log NT-proBNP and 0.79 (0.73; 0.86) per 1-SD increase of log MR-proANP. These associations were still significant after further adjustment (HR 0.84 [95% CI, 0.79; 0.89] per 1-SD increase of log NT-proBNP and HR 0.77 [95% CI, 0.71; 0.83] per 1-SD increase of log MR-proANP).
NT-proBNP was significantly inversely associated with incident T2D in participants without CVD history but not in those with CVD history. The multivariable HRs (95% CIs) per 1-SD increase were 0.81 (0.76; 0.86) in participants without CVD history and 1.04 (0.90; 1.19) in those with CVD history.
Regarding MR-proANP, no significant difference was observed in the association with incident T2D for participants with and without CVD history (P = .236 for interaction on the multiplicative scale and P = .441 on the additive scale). The multivariable HRs (95% CIs) per 1-SD increase were 0.81 (0.66; 0.99) in participants with CVD history and 0.75 (0.69; 0.82) in those without CVD history.
The study authors noted that T2D incidence was mainly based on medical reviews, as well as self-report for a small number of individuals, which may have led to misclassification of incident cases. Patient CVD history was also based on medical review or self-report. In addition, only 1 measurement of NT-proBNP and MR-proANP were available at baseline, and so intraindividual variation could not be taken into account.
“Future studies are needed to examine the underlying mechanisms, the differences in the metabolic actions between both NPs, and their potential as targets for therapeutic interventions of T2D,” stated the researchers.
Disclosure: Some of the study authors declared affiliations with pharmaceutical companies. Please see the original reference for a full list of authors’ disclosures.
Sujana C, Salomaa V, Kee F, et al for the BiomarCaRE Consortium. Natriuretic peptides and risk of type 2 diabetes: results from the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium. Diabetes Care. Published online September 14, 2021. doi:10.2337/dc21-0811
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