Short-term changes in circulating insulin and free fatty acids affect Nt-pro-BNP levels in heart failure patients

• Published in: International journal of cardiology 2010-09, Vol.144 (1), p.140-142
• Main Authors: Halbirk, Mads, Nørrelund, Helene, Møller, Niels, Schmitz, Ole, Bøtker, Hans Erik, Wiggers, Henrik
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers - blood; BNP; Cardiology. Vascular system; Cardiovascular; Fatty Acids, Nonesterified - blood; Follow-Up Studies; Free fatty acids; Heart; Heart failure; Heart Failure - blood; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Insulin; Insulin - blood; Male; Medical sciences; Natriuretic Peptide, Brain - blood; Nt-pro-BNP; Peptide Fragments - blood; Protein Precursors; Severity of Illness Index; Time Factors
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2008.12.152

Abstract Background Discriminatory values have been defined for both N-terminal-pro Brain Natriuretic Peptide (Nt-pro-BNP) and BNP but the general values established so far are controversial in insulin resistant patients due to their lower levels of natriuretic peptides. The aim of the present study was to address whether short-term modulation of insulin and FFA affects Nt-pro-BNP and BNP levels in heart failure patients. Methods In a crossover design eight male non-diabetic patients with chronic heart failure and ischemic heart disease were studied during an euglycemic insulin clamp and during a heparin/somatostatin infusion. Results The influence of insulin and heparin infusions on absolute and relative Nt-pro-BNP levels differed at steady state. During the euglycemic insulin clamp Nt-pro-BNP levels decreased when compared to heparin/somatostatin infusion [change in Nt-pro-BNP (pg ml − 1 ): − 21 pg/ml ± 9 (insulin) vs. − 4 pg/ml ± 8 (heparin), P = 0.038]. Neither urinary Nt-pro-BNP excretion nor hemodynamics differed. Conclusion Short term modulation of circulating insulin and FFA concentrations by glucose-insulin and heparin-somatostatin infusions affects circulating Nt-pro-BNP concentrations. These findings indicate that factors other than cardiac status impact on BNP and NT-pro-BNP concentrations and support the proposal that discriminatory Nt-pro-BNP values should be decreased in insulin resistant individuals.