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01.12.2012 | Original investigation | Ausgabe 1/2012 Open Access

Cardiovascular Diabetology 1/2012

Plasma NT-proBNP and white matter hyperintensities in type 2 diabetic patients

Zeitschrift:
Cardiovascular Diabetology > Ausgabe 1/2012
Autoren:
Henrik Reinhard, Ellen Garde, Arnold Skimminge, Per Åkeson, Thomas Zoëga Ramsøy, Kaj Winther, Hans-Henrik Parving, Peter Rossing, Peter K Jacobsen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2840-11-119) contains supplementary material, which is available to authorized users.

Competing interests

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.

Author contributions

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.

Abstract

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.

Methods and results

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.

Conclusion

P-NT-proBNP was associated with WMH in type 2 diabetic patients, suggesting a linkage between heart and brain disease.
Zusatzmaterial
Authors’ original file for figure 1
12933_2012_550_MOESM1_ESM.pdf
Authors’ original file for figure 2
12933_2012_550_MOESM2_ESM.pdf
Literatur
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