1
|
Chen P, Yan P, Wan Q, Zhang Z, Xu Y, Miao Y, Yang J. Association of circulating B-type natriuretic peptide with osteoporosis in a Chinese type 2 diabetic population. BMC Musculoskelet Disord 2021; 22:261. [PMID: 33691659 PMCID: PMC7944612 DOI: 10.1186/s12891-021-04138-3] [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] [Received: 05/15/2020] [Accepted: 02/28/2021] [Indexed: 02/05/2023] Open
Abstract
Background Altered circulating levels and genetic variation of B-type natriuretic peptide (BNP), has been associated with lower bone mineral density (BMD) values and incidence of osteoporosis in peritoneal dialysis patients, renal transplant recipients, and postmenopausal women. The potential relationship of circulating BNP with osteoporosis in patients with type 2 diabetes mellitus (T2DM), however, has not yet been studied. Methods Circulating BNP levels were measured in 314 patients with T2DM, and participants were divided into normal BMD group (n = 73), osteopenia group (n = 120), and osteoporosis group (n = 121). The association of circulating BNP with diabetic osteoporosis and other parameters was analyzed. Results Circulating BNP was significantly higher in diabetic osteoporosis subjects than normal and osteopenia groups (P < 0.01 or P < 0.05). Circulating BNP levels correlated significantly and positively with neutrophil to lymphocyte ratio, systolic blood pressure, urinary albumin-to-creatinine ratio, and prevalence of hypertension, peripheral arterial disease, diabetic retinopathy, peripheral neuropathy, and nephropathy, and negatively with triglyceride, fasting blood glucose, lymphocyte count, hemoglobin, estimated glomerular filtration rate, bilirubin, osteoporosis self-assessment tool for Asians, BMD at different skeletal sites and corresponding T scores (P < 0.01 or P < 0.05). After multivariate adjustment, circulating BNP remained independently significantly associated with the presence of osteoporosis (odds ratio, 2.710; 95% confidence interval, 1.690–4.344; P < 0.01). BMD at the femoral neck and total hip and corresponding T scores were progressively decreased, whereas the prevalence of osteoporosis was progressively increased with increasing BNP quartiles (P for trend< 0.01). Moreover, receiver-operating characteristic analysis revealed that the optimal cutoff point of circulating BNP to indicate diabetic osteoporosis was 16.35 pg/ml. Conclusions Circulating BNP level may be associated with the development of osteoporosis, and may be a potential biomarker for diabetic osteoporosis.
Collapse
Affiliation(s)
- Pan Chen
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Pijun Yan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Qin Wan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Zhihong Zhang
- Department of General Medicine, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping street, Luzhou, 646000, Sichuan, China
| | - Yong Xu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Ying Miao
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Jun Yang
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| |
Collapse
|
2
|
Yan P, Wan Q, Zhang Z, Xu Y, Miao Y, Chen P, Gao C. Association between Circulating B-Type Natriuretic Peptide and Diabetic Peripheral Neuropathy: A Cross-Sectional Study of a Chinese Type 2 Diabetic Population. J Diabetes Res 2020; 2020:3436549. [PMID: 33110921 PMCID: PMC7578714 DOI: 10.1155/2020/3436549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 01/30/2023] Open
Abstract
Cardiovascular disease which is associated with cardiac dysfunction, usually measured with circulating levels of B-type natriuretic peptide (BNP), has been associated with incidence and progression of diabetic peripheral neuropathy (DPN). The potential relationship of circulating physiological levels of BNP with DPN, however, has not been reported. Circulating levels of BNP were measured in 258 patients with type 2 diabetes mellitus (T2DM), and participants were divided into a DPN group (n = 61) and no DPN group (n = 197). The relationship between circulating physiological levels of BNP and DPN and other parameters was analyzed. Circulating levels of BNP were significantly elevated in T2DM patients with DPN compared to those without (P = 0.001). Circulating levels of BNP were significantly and positively associated with systolic blood pressure (P = 0.035), neutrophil-to-lymphocyte ratio (P = 0.007), creatinine (P = 0.030), vibration perception threshold values (P = 0.021), and the prevalence of diabetic foot ulceration (P = 0.039), peripheral arterial disease (P = 0.013), DPN (P = 0.032), and diabetic nephropathy (P = 0.020) and negatively with lymphocyte count (P = 0.003) and ankle-brachial index (P = 0.038), irrespective of age, sex, and body mass index. Moreover, circulating levels of BNP was an independent decisive factor for the presence of DPN after multivariate adjustment (odds ratio, 1.044; 95% confidence interval, 1.006-1.084; P = 0.024). Additionally, the higher quartiles of circulating BNP were related significantly to an increased risk of DPN compared to the lowest quartile (P = 0.003). Last but most importantly, the analysis of receiver operating characteristic curves revealed that the best cutoff value for circulating levels of BNP to predict DPN was 15.18 pg/mL (sensitivity 78.7% and specificity 48.2%). These findings suggest that high circulating physiological levels of BNP may be associated with the development of DPN and may be a potential biomarker for DPN in patients with T2DM.
Collapse
Affiliation(s)
- Pijun Yan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Qin Wan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Zhihong Zhang
- Department of General Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yong Xu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Ying Miao
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Pan Chen
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Chenlin Gao
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| |
Collapse
|
3
|
Fahmy EM, El Mahdi AM, Gaber MA, Saeed MAM. Does brain natriuretic peptide have a significant diagnostic value in subclinical peripheral atrial disease type 2 diabetic patients? THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2017. [DOI: 10.4103/ejim.ejim_58_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
Serum carboxy-terminal telopeptide of type I collagen (I-CTP) is predictive of clinical outcome in peripheral artery disease patients following endovascular therapy. Heart Vessels 2016; 32:149-156. [DOI: 10.1007/s00380-016-0858-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
|
5
|
Fathy SA, Abdel Hamid FF, Zabut BM, Jamee AF, Ali MAM, Abu Mustafa AM. Diagnostic utility of BNP, corin and furin as biomarkers for cardiovascular complications in type 2 diabetes mellitus patients. Biomarkers 2015; 20:460-9. [PMID: 26488448 DOI: 10.3109/1354750x.2015.1093032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
CONTEXT The number of patients with type 2 diabetes mellitus (T2DM) is progressively increasing, and diabetic cardiovascular complications have become a public health problem. Brain or B-type natriuretic peptide (BNP) is a cardiac hormone synthesized as a pre-pro-peptide. pro-BNP is produced by cleaving the signal peptide then two proprotein convertases, corin and furin cleave pro-BNP to form a biologically active hormone. Two corin single nucleotide polymorphisms (SNPs) have been reported to alter corin protein conformation and impair its biological activity. OBJECTIVE We aimed to investigate the potential role of corin and furin in comparison to BNP as biomarkers for predicting cardiovascular complications in T2DM patients. The association of corin gene SNPs with corin levels was also examined. METHODS Seventy-five subjects were recruited in this study, including 25 T2DM patients with complications, 25 T2DM patients without complications as well as 25 healthy subjects. Plasma BNP, corin and furin levels were measured using enzyme-linked immunosorbent assays. Two corin SNPs were genotyped using allele specific oligonucleotide-polymerase chain reaction. RESULTS Both furin and BNP were found to be more sensitive than corin (80% versus 56%, p = 0.008), whereas furin showed higher specificity when compared to BNP (96% versus 84%, p = 0.041) and corin (96% versus 64%, p < 0.0001) in predicting cardiovascular complications in T2DM patients. Corin SNPs are not associated with corin levels, neither in the entire study cohort nor in the subgroup of T2DM patients with cardiovascular complications (p > 0.05). CONCLUSIONS Furin may be useful, either alone or in combination with other biomarkers, for cardiovascular risk stratification assessment in T2DM patients.
Collapse
Affiliation(s)
- Shadia A Fathy
- a Department of Biochemistry , Faculty of Science, Ain Shams University , Cairo , Egypt
| | - Fatma F Abdel Hamid
- a Department of Biochemistry , Faculty of Science, Ain Shams University , Cairo , Egypt
| | - Baker M Zabut
- b Biochemistry Department , Faculty of Science, Islamic University , Gaza , Palestine
| | - Amal F Jamee
- c Cardiology Department , El-Shifa Hospital , Gaza , Palestine , and
| | - Mohamed A M Ali
- a Department of Biochemistry , Faculty of Science, Ain Shams University , Cairo , Egypt
| | - Ayman M Abu Mustafa
- d General Directorate of Human Resources Development, Ministry of Health , Gaza , Palestine
| |
Collapse
|
6
|
Song X, Jia H, Jiang Y, Wang L, Zhang Y, Mu Y, Liu Y. Anti-atherosclerotic effects of the glucagon-like peptide-1 (GLP-1) based therapies in patients with type 2 Diabetes Mellitus: A meta-analysis. Sci Rep 2015; 5:10202. [PMID: 26111974 PMCID: PMC4481643 DOI: 10.1038/srep10202] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 04/07/2015] [Indexed: 12/24/2022] Open
Abstract
This study assessed the effect of GLP-1 based therapies on atherosclerotic markers in type 2 diabetes patients. 31 studies were selected to obtain data after multiple database searches and following inclusion and exclusion criteria. Age and BMI of the participants of longitudinal studies were 59.8 ± 8.3 years and 29.2 ± 5.7 kg/m2 (Mean±SD). Average duration of GLP-1 based therapies was 20.5 weeks. Percent flow-mediated diameter (%FMD) did not change from baseline significantly but when compared to controls, %FMD increased non-significantly following GLP-1-based therapies (1.65 [−0.89, 4.18]; P = 0.2; REM) in longitudinal studies and increased significantly in cross sectional studies (2.58 [1.68, 3.53]; P < 0.00001). Intima media thickness decreased statistically non-significantly by the GLP-1 based therapies. GLP-1 based therapies led to statistically significant reductions in the serum levels of brain natriuretic peptide (−40.16 [−51.50, −28.81]; P < 0.0001; REM), high sensitivity c-reactive protein (−0.27 [−0.48, −0.07]; P = 0.009), plasminogen activator inhibitor-1 (−12.90 [−25.98, 0.18]; P=0.05), total cholesterol (−5.47 [−9.55, −1.39]; P = 0.009), LDL-cholesterol (−3.70 [−7.39, −0.00]; P = 0.05) and triglycerides (−16.44 [−25.64, −7.23]; P = 0.0005) when mean differences with 95% CI in the changes from baselines were meta-analyzed. In conclusion, GLP-1-based therapies appear to provide beneficial effects against atherosclerosis. More randomized data will be required to arrive at conclusive evidence.
Collapse
Affiliation(s)
- Xiaoyan Song
- 1] Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China [2] Department of Endocrinology, Chinese PLA 309 Hospital, Beijing 100091, China
| | - Hetang Jia
- Department of Endocrinology, Chinese PLA 309 Hospital, Beijing 100091, China
| | - Yuebo Jiang
- Department of Acupuncture, Chinese PLA General Hospital, Beijing 100853, China
| | - Liang Wang
- Department of Orthopedics, Chinese PLA 309 Hospital, Beijing 100091
| | - Yan Zhang
- Department of Orthopedics, Chinese PLA 309 Hospital, Beijing 100091
| | - Yiming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
| | - Yu Liu
- Department of Geriatric Endocrinology, General Hospital of PLA, Beijing 100853, China
| |
Collapse
|
7
|
Heart-type fatty acid binding protein and high-sensitivity troponin T are myocardial damage markers that could predict adverse clinical outcomes in patients with peripheral artery disease. BBA CLINICAL 2015; 4:35-41. [PMID: 26673681 PMCID: PMC4661598 DOI: 10.1016/j.bbacli.2015.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 06/16/2015] [Indexed: 11/24/2022]
Abstract
Background Despite many recent advances in endovascular therapy (EVT), peripheral artery disease (PAD) is an increasing health problem with high mortality. Heart-type fatty acid-binding protein (H-FABP) and high-sensitivity troponin T (hsTnT) are markers of ongoing myocardial damage and have been reported to be useful indicators of future cardiovascular events. However, it remains to be determined whether H-FABP and hsTnT can predict adverse clinical outcomes in patients with PAD. Methods and results We enrolled 208 de novo PAD patients who underwent EVT. Serum H-FABP and hsTnT were measured in all patients before EVT. During the median follow-up period of 694 days, there were 40 major adverse cardiovascular and cerebrovascular events (MACCEs) including all-cause deaths, and re-hospitalizations due to cardiovascular and cerebrovascular diseases and amputations. H-FABP and hsTnT were found to be higher in patients with critical limb ischemia (CLI) compared to those without this condition. Multivariate Cox proportional hazard regression analysis revealed that both H-FABP and hsTnT were independent predictors of MACCEs after adjustment for confounding factors. Kaplan–Meier analysis demonstrated that patients in the highest tertile according to H-FABP levels, as well as those in the highest hsTnT tertile, were at greatest risk for MACCEs. The net reclassification index was significantly improved by the addition of H-FABP as well as the addition of hsTnT to traditional risk factors. Conclusion The myocardial damage markers H-FABP and hsTnT were increased in PAD patients with CLI and could predict MACCEs in PAD patients.
Collapse
|