N-terminal pro-Brain Natriuretic Peptide and Risk of Diabetes

  1. Elizabeth Selvin, PhD, MPH1,2
  1. 1Department of Medicine, Division of General Internal Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
  2. 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
  3. 3Department of Medicine, Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, Texas.
  1. Corresponding author: Mariana Lazo, E-mail: mlazoel1{at}


Brain natriuretic peptide (BNP) has an established role in cardiovascular disease. However, recent animal studies suggest direct metabolic effects of BNP. To determine the association of BNP with the risk of diabetes, we conducted a prospective analysis of participants from the Atherosclerosis Risk in Communities (ARIC) Study. We included 7,822 men and women without history of diabetes, cardiovascular disease or reduced kidney function at baseline. At baseline, N-terminal (NT)-proBNP, a cleavage product of BNP, was inversely associated with adiposity, fasting glucose, insulin, and cholesterol, but positively associated with blood pressure and C-reactive protein levels. During a median follow-up of 12 years, 1740 participants reported a new diagnosis of diabetes or medication use for diabetes. Baseline quartiles of NT-proBNP were inversely associated with diabetes risk, even after multivariable adjustment including fasting glucose. The adjusted HRs for diabetes were 1.0 (reference), 0.84 (95%CI 0.74- 0.96), 0.79 (95%CI 0.68- 0.90) and 0.75 (95%CI 0.64-0.87) for the 1st, 2nd, 3rd and 4th quartiles of baseline NT-proBNP, respectively (p-for-trend<0.001). This inverse association was robust across sex, race and obesity subgroups. Our results extend animal studies and support a direct and important metabolic role of BNP in humans.

  • Received March 24, 2013.
  • Accepted May 29, 2013.

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