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Thomsen CF, Goharian TS, Larsen KT, Goetze JP, Andersen LB, Jeppesen JL. Intensive Lifestyle Intervention Increases Plasma Midregional Proatrial Natriuretic Peptide Concentrations in Overweight Children. J Am Heart Assoc 2021; 10:e020676. [PMID: 34180245 PMCID: PMC8403313 DOI: 10.1161/jaha.121.020676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Overweight adults have low circulating concentrations of ANP (atrial natriuretic peptide) and proANP fragments. We tested the hypothesis that an intensive lifestyle intervention with an intended weight loss would increase plasma concentrations of a proANP fragment in overweight children. Methods and Results We measured MR‐proANP (midregional proANP) concentrations in plasma from overweight children who participated in the OOIS (Odense Overweight Intervention Study). OOIS randomized 115 overweight children (11–13 years, 55% girls) to an intensive day‐camp intervention arm with increased physical activity and healthy diet or to a less intensive standard intervention arm for 6 weeks. We used linear mixed‐effects modeling for repeated measures to estimate the difference in the mean change with 95% CIs in fasting plasma MR‐proANP concentrations between the 2 arms, and we used partial least squares regression analysis to identify candidate mediators. Differences in weight, fitness, and metabolic factors were also analyzed. At baseline, fasting plasma MR‐proANP concentrations were (median [interquartile range]) 35.0 pmol/L (26.8–42.0) in the day‐camp intervention arm and 37.2 pmol/L (31.7–44.7) in standard intervention arm participants, respectively. After 6 weeks intervention, children in the day‐camp intervention arm had increased their MR‐proANP (5.4 pmol/L [0.8–10.0], P=0.022) and their fitness (2.33 mL O2/min per kg [0.52–4.14], P=0.012) and they had deceased their body mass index (−2.12 kg/m2 [−2.59 to −1.65], P<0.001) as compared with children in standard intervention arm. In the partial least squares analysis, decreases in fasting insulin and in estimated insulin resistance were associated with the observed increase in MR‐proANP concentrations. Conclusions An intensive lifestyle intervention increases plasma MR‐proANP among overweight children. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01574352.
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Affiliation(s)
- Camilla F Thomsen
- Department of Medicine Amager Hvidovre Hospital in GlostrupUniversity of Copenhagen Glostrup Denmark
| | - Tina S Goharian
- Department of Clinical Biochemistry Nordsjællands Hospital HillerødUniversity of Copenhagen Hillerød Denmark
| | - Kristian T Larsen
- Center of Research in Childhood Health (RICH) Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark
| | - Jens P Goetze
- Department of Clinical Biochemistry Rigshospitalet BlegdamsvejUniversity of Copenhagen Denmark.,Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Denmark
| | - Lars B Andersen
- Department of Sport, Food, and Natural Sciences Campus SogndalWestern Norway University of Applied Sciences, Sogndal Norway
| | - Jørgen L Jeppesen
- Department of Medicine Amager Hvidovre Hospital in GlostrupUniversity of Copenhagen Glostrup Denmark.,Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Denmark
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Asferg CL, Andersen UB, Linneberg A, Hedley PL, Christiansen M, Goetze JP, Jeppesen JL. Serum B-type natriuretic peptide does not increase with higher systolic blood pressure in obese men despite evidence of blood pressure-related increases in left ventricular mass and filling pressure. Peptides 2020; 134:170390. [PMID: 32882353 DOI: 10.1016/j.peptides.2020.170390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 11/27/2022]
Abstract
B-type natriuretic peptide (BNP) is a cardiac hormone secreted predominantly from the ventricles in response to increased ventricular pressure. Along this line, hypertensive patients with left ventricular hypertrophy typically have high circulating BNP concentrations. BNP has natriuretic and vasodilatory actions. Obese persons have low circulating BNP concentrations, and a relative lack of this natriuretic and vasodilatory factor could contribute to obesity-related hypertension. The relationship between BNP, BP, left ventricular mass (LVM), and left ventricular filling pressure among obese persons is not clear. To address this issue, we studied 98 healthy obese medication-free men with normal left ventricular ejection fraction. We measured BP using 24 -h ambulatory (A) BP recordings, LVM and E/e', an estimate of left ventricular filling pressure, using echocardiography, and fasting BNP in serum. Mean systolic ABP ± SD was 114 ± 4 mm Hg in 1st and 149 ± 8 mm Hg in 4th systolic ABP quartile, P < 0.001. LVM and E/e' increased across systolic ABP quartiles (mean LVM±SD: 81.5±13.7 g/m2 in 1st and 100.1 ± 26.7 g/m2 in 4th quartile, P = 0.018; mean E/e'±SD: 5.3±1.6 in 1st and 7.0 ± 2.0 in 4th quartile, P = 0.002). In contrast, serum BNP did not increase across systolic ABP quartiles (median (IQR): 6.7 (3.1-12.3) pg/ml in 1st and 5.3 (2.8-9.7) pg/ml in 4th quartile, P = 0.75). Unexpectedly, among healthy obese medication-free men, serum BNP does not increase with higher systolic ABP despite evidence of BP-related increases in LVM and E/e'. This further suggests that a relatively low amount of circulating BNP could contribute to obesity-related hypertension in its early stages.
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Affiliation(s)
- Camilla L Asferg
- Department of Cardiology, Zealand University Hospital, Roskilde, University of Copenhagen, Roskilde, Denmark.
| | - Ulrik B Andersen
- Department of Clinical Physiology, Nuclear Medicine, and PET, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Capital Region, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Paula L Hedley
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Michael Christiansen
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens P Goetze
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Rigshospitalet Blegdamsvej, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen L Jeppesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Medicine, Amager Hvidovre Hospital in Glostrup, University of Copenhagen, Glostrup, Denmark
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Salo PP, Havulinna AS, Tukiainen T, Raitakari O, Lehtimäki T, Kähönen M, Kettunen J, Männikkö M, Eriksson JG, Jula A, Blankenberg S, Zeller T, Salomaa V, Kristiansson K, Perola M. Genome-Wide Association Study Implicates Atrial Natriuretic Peptide Rather Than B-Type Natriuretic Peptide in the Regulation of Blood Pressure in the General Population. CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:e001713. [PMID: 29237677 PMCID: PMC6072381 DOI: 10.1161/circgenetics.117.001713] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 10/03/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cardiomyocytes secrete atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in response to mechanical stretching, making them useful clinical biomarkers of cardiac stress. Both human and animal studies indicate a role for ANP as a regulator of blood pressure with conflicting results for BNP. METHODS AND RESULTS We used genome-wide association analysis (n=6296) to study the effects of genetic variants on circulating natriuretic peptide concentrations and compared the impact of natriuretic peptide-associated genetic variants on blood pressure (n=27 059). Eight independent genetic variants in 2 known (NPPA-NPPB and POC1B-GALNT4) and 1 novel locus (PPP3CC) associated with midregional proANP (MR-proANP), BNP, aminoterminal proBNP (NT-proBNP), or BNP:NT-proBNP ratio. The NPPA-NPPB locus containing the adjacent genes encoding ANP and BNP harbored 4 independent cis variants with effects specific to either midregional proANP or BNP and a rare missense single nucleotide polymorphism in NT-proBNP seriously altering its measurement. Variants near the calcineurin catalytic subunit gamma gene PPP3CC and the polypeptide N-acetylgalactosaminyltransferase 4 gene GALNT4 associated with BNP:NT-proBNP ratio but not with BNP or midregional proANP, suggesting effects on the post-translational regulation of proBNP. Out of the 8 individual variants, only those correlated with midregional proANP had a statistically significant albeit weak impact on blood pressure. The combined effect of these 3 single nucleotide polymorphisms also associated with hypertension risk (P=8.2×10-4). CONCLUSIONS Common genetic differences affecting the circulating concentration of ANP associated with blood pressure, whereas those affecting BNP did not, highlighting the blood pressure-lowering effect of ANP in the general population.
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Verboven K, Hansen D, Jocken JWE, Blaak EE. Natriuretic peptides in the control of lipid metabolism and insulin sensitivity. Obes Rev 2017; 18:1243-1259. [PMID: 28901677 DOI: 10.1111/obr.12598] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/08/2017] [Accepted: 07/20/2017] [Indexed: 12/24/2022]
Abstract
Natriuretic peptides have long been known for their cardiovascular function. However, a growing body of evidence emphasizes the role of natriuretic peptides in human substrate and energy metabolism, thereby connecting the heart with several insulin-sensitive organs like adipose tissue, skeletal muscle and liver. Obesity may be associated with an impaired regulation of the natriuretic peptide system, also indicated as a natriuretic handicap. Evidence points towards a contribution of this natriuretic handicap to the development of obesity, type 2 diabetes mellitus and cardiometabolic complications, although the causal relationship is not fully understood. Nevertheless, targeting the natriuretic peptide pathway may improve metabolic health in obesity and type 2 diabetes mellitus. This review will focus on current literature regarding the metabolic roles of natriuretic peptides with emphasis on lipid metabolism and insulin sensitivity. Furthermore, it will be discussed how exercise and lifestyle intervention may modulate the natriuretic peptide-related metabolic effects.
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Affiliation(s)
- K Verboven
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - D Hansen
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - J W E Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - E E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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