N -Terminal Pro–B-type Natriuretic Peptide Is Inversely Related to Bone Mineral Density in Renal Transplant Recipients

• Published in: Transplantation proceedings 2014-12, Vol.46 (10), p.3443-3447
• Main Authors: Lee, M.-C, Lee, C.-J, Shih, M.-H, Ho, G.-J, Chen, Y.-C, Hsu, B.-G
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; Bone Density - physiology; Female; Humans; Kidney Transplantation; Male; Middle Aged; Natriuretic Peptide, Brain - blood; Osteoporosis - blood; Osteoporosis - diagnostic imaging; Peptide Fragments - blood; Protein Precursors; Surgery; Transplant Recipients
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.06.077

Abstract Introduction Bone mineral density (BMD) was significantly lower in heart failure patients. Our aim was to evaluate the relationship between BMD and fasting serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration in renal transplant recipients. Methods Fasting blood samples were obtained from 69 renal transplant recipients. BMD was measured by dual energy x-ray absorptiometry in lumbar vertebrae (L2–L4). Serum NT-proBNP levels were measured by electrochemiluminescence immunoassay. Results Among the renal transplant recipients, 8 patients (11.6%) had osteoporosis and 28 (40.6%) had osteopenia; 33 had a normal BMD. Increased serum NT-proBNP ( P  < .001) and decreased body mass index ( P  = .033) and body weight ( P  = .010) were significantly correlated with low lumbar T-score cutoff points between groups (normal, osteopenia, and osteoporosis). Women had lower lumbar BMD than did men ( P  = .013). Menopause in women ( P  = .005), use of tacrolimus ( P  = .020), and use of cyclosporine ( P  = .046) among renal transplant recipients were associated with lower lumbar BMD. Multivariate forward stepwise linear regression analysis of the significant variables revealed that log-transformed NT-proBNP ( β , −0.545; R2  = 0.331; P  < .001), and body weight ( β , 0.273, R2  = 0.104; P  = .005) were independent predictors of lumbar BMD values among the renal transplant recipients. Conclusions Serum NT-proBNP concentrations correlate negatively with lumbar BMD values among renal transplant recipients and may be an alternative to energy x-ray absorptiometry for identifying at risk of osteoporosis in renal transplant recipients.