Midregional Proatrial Natriuretic Peptide (MRproANP) is associated with vertebral fractures and low bone mineral density (BMD) in patients with COPD

Trudzinski, Franziska ; Jörres, Rudolf A. ; Alter, Peter ; Watz, Henrik; Vogelmeier, Claus F. ; Kauczor, Hans-Ulrich ; Thangamani, Subasini; Debic, Manuel; Welte, Tobias ; Behr, Jürgen ; Kahnert, Kathrin ; Bals, Robert; Herr, Christian; Heußel, Claus Peter; Biederer, Jürgen ; Stackelberg, Oyunbileg von; Fähndrich, Sebastian; Wouters, Emiel F. M.; Waschki, Benjamin ; Rabe, Klaus F. ; Herth, Felix J.F. und Palm, Viktoria (2024): Midregional Proatrial Natriuretic Peptide (MRproANP) is associated with vertebral fractures and low bone mineral density (BMD) in patients with COPD. In: European Respiratory Journal, Bd. 64, Nr. Suppl. 68, PA3888

Abstract

Background Patients with COPD are often afected by loss of bone mineral density (BMD) and osteoporotic fractures. Natriuretic peptides (NP) are known as cardiac markers, but have also been linked to fragility-associated fractures in the elderly. As their functions include regulation of fuid and mineral balance, they also might afect bone metabolism, particularly in systemic disorders such as COPD.

Research question We investigated the association between NP serum levels, vertebral fractures and BMDassessed by chest computed tomography (CT) in patients with COPD.

Methods Participants of the COSYCONET cohort with CT scans were included. Mean vertebral bone density on CT (BMD-CT) as a risk factor for osteoporosis was assessed at the level of TH12 (AI-Rad Companion), and vertebral co pression fractures were visually quantifed by two readers. Their relationship with N-terminal pro-B-type natriuret peptide (NT-proBNP), Mid-regional pro-atrial natriuretic peptide (MRproANP) and Midregional pro-adrenomedul (MRproADM) was determined using group comparisons and multivariable analyses.

Results Among 418 participants (58% male, median age 64 years, FEV1 59.6% predicted), vertebral fractures in TH12 were found in 76 patients (18.1%). Compared to patients without fractures, these had elevated serum levels (p≤0.005) of MRproANP and MRproADM. Using optimal cut-of values in multiple logistic regression analyses, MRproANP levels≥65 nmol/l (OR 2.34; p=0.011) and age (p=0.009) were the only signifcant predictors of fractures after adjustment for sex, BMI, smoking status, FEV1% predicted, SGRQ Activity score, daily physical activity, oral corticosteroids, the diagnosis of cardiac disease, and renal impairment. Correspondingly, MRproANP (p<0.001), age (p=0.055), SGRQ Activity score (p=0.061) and active smoking (p=0.025) were associated with TH12 vertebral density

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0903-1936 ; 1399-3003
• Sprache: Englisch