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Sujana, Chaterina; Salomaa, Veikko; Kee, Frank; Costanzo, Simona; Soderberg, Stefan; Jordan, Jens; Jousilahti, Pekka; Neville, Charlotte; Iacoviello, Licia; Oskarsson, Viktor; Westermann, Dirk; Koenig, Wolfgang; Kuulasmaa, Kari; Reinikainen, Jaakko; Blankenberg, Stefan; Zeller, Tanja; Herder, Christian; Mansmann, Ulrich; Peters, Annette und Thorand, Barbara (2021): Natriuretic Peptides and Risk of Type 2 Diabetes: Results From the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium. In: Diabetes Care, Bd. 44, Nr. 11: S. 2527-2535

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Abstract

OBJECTIVE Natriuretic peptide (NP) concentrations are increased in cardiovascular diseases (CVDs) but are associated with a lower diabetes risk. We investigated associations of N-terminal pro-B-type NP (NT-proBNP) and midregional proatrial NP (MR-proANP) with incident type 2 diabetes stratified by the presence of CVD. RESEARCH DESIGN AND METHODS Based on the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium, we included 45,477 participants with NT-proBNP measurements (1,707 developed type 2 diabetes over 6.5 years of median follow-up;among these, 209 had CVD at baseline) and 11,537 participants with MR-proANP measurements (857 developed type 2 diabetes over 13.8 years of median follow-up;among these, 106 had CVD at baseline). The associations were estimated using multivariable Cox regression models. RESULTS Both NPs were inversely associated with incident type 2 diabetes (hazard ratios [95% CI] per 1-SD increase of log NP: 0.84 [0.79;0.89] for NT-proBNP and 0.77 [0.71;0.83] for MR-proANP). The inverse association between NT-proBNP and type 2 diabetes was significant in individuals without CVD but not in individuals with CVD (0.81 [0.76;0.86] vs. 1.04 [0.90;1.19];P multiplicative interaction = 0.001). There was no significant difference in the association of MR-proANP with type 2 diabetes between individuals without and with CVD (0.75 [0.69;0.82] vs. 0.81 [0.66;0.99];P multiplicative interaction = 0.236). CONCLUSIONS NT-proBNP and MR-proANP are inversely associated with incident type 2 diabetes. However, the inverse association of NT-proBNP seems to be modified by the presence of CVD. Further investigations are warranted to confirm our findings and to investigate the underlying mechanisms.

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