The online version of this article (doi:10.1186/1475-2840-11-119) contains supplementary material, which is available to authorized users.
Dr. Rossing reports having received lecture fees from Novartis and Boehringer Ingelheim, and research grant from Novartis, has served as a consultant for Merck, and having equity interest in NovoNordisk. Dr. Parving reports having served as a consultant for Novartis, Merck, Pfizer and Sanofi-Aventis, having equity interest in Merck and NovoNordisk and having received lecture fees from Novartis, Merck, Pfizer and Sanofi-Aventis. Dr. Parving has received grant support from Novartis, AstraZeneca and Sanofi-Aventis.
H.R: researched data, contributed to discussion, wrote manuscript. E.G., A.S, P.Å, T.R, K.W, PK.J, P.R, H-H.P: researched data, contributed to discussion, reviewed/edited manuscript. All authors read and approved the final manuscript.
Elevated plasma N-terminal (NT)-proBNP from the heart as well as white matter hyperintensities (WMH) in the brain predict cardiovascular (CV) mortality in the general population. The cause of poor prognosis associated with elevated P-NT-proBNP is not known but WMH precede strokes in high risk populations. We assessed the association between P-NT-proBNP and WMH or brain atrophy measured with magnetic resonance imaging (MRI) in type 2 diabetic patients, and age-matched controls.
We measured P-NT-proBNP(ng/l) in 20 diabetic patients without prior stroke but with(n = 10) or without(n = 10) asymptomatic coronary artery disease(CAD) in order to include patients with a wide-ranging CV risk profile. All patients and 26 controls had a 3D MRI and brain volumes(ml) with WMH and brain parenchymal fraction(BPF), an indicator of brain atrophy, were determined.
P-NT-proBNP was associated with WMH in linear regression analysis adjusted for CV risk factors(r = 0.94, p = 0.001) and with BPF in univariate analysis(r = 0.57, p = 0.009). Patients divided into groups of increased P-NT-proBNP levels were paralleled with increased WMH volumes(geometric mean[SD];(2.86[5.11] ml and 0.76[2.49] ml compared to patients with low P-NT-proBNP 0.20[2.28] ml, p = 0.003)) and also when adjusted for age, sex and presence of CAD(p = 0.017). The association was strengthened by CV risk factors and we did not find a common heart or brain specific driver of both P-NT-proBNP and WMH. Patients and particular patients with CAD had higher WMH, however no longer after adjustment for age and sex.
P-NT-proBNP was associated with WMH in type 2 diabetic patients, suggesting a linkage between heart and brain disease.
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- Plasma NT-proBNP and white matter hyperintensities in type 2 diabetic patients
Thomas Zoëga Ramsøy
Peter K Jacobsen
- BioMed Central
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