Comment on: Vila et al. B-Type Natriuretic Peptide Modulates Ghrelin, Hunger, and Satiety in Healthy Men. Diabetes 2012;61:2592–2596

  1. Andreas L. Birkenfeld2
  1. From the 1Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany; and the
  2. 2Department of Endocrinology, Diabetes and Nutrition, Center for Cardiovascular Research, Charité–University School of Medicine, Berlin, Germany
  1. Corresponding author: Andreas L. Birkenfeld, andreas.birkenfeld{at}

Vila et al. (1) reported that brain natriuretic peptide (BNP) infusions reduce total and acylated-ghrelin levels while increasing satiety. Since ghrelin acts orexigenic, the authors conclude that BNP might indirectly regulate food intake in conditions associated with excessive BNP levels, such as in heart failure. The hypothesis is provocative but ignores the complex metabolic actions of natriuretic peptides.

Because ghrelin stimulates hypothalamic AMP-activated protein …

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