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Clinical Chemistry 51: 138-143, 2005. First published November 18, 2004; 10.1373/clinchem.2004.035923
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Right arrow Proteomics and Protein Markers
(Clinical Chemistry. 2005;51:138-143.)
© 2005 American Association for Clinical Chemistry, Inc.

Lipids, Lipoproteins, and Cardiovascular Risk Factors

N-Terminal Pro-B-Type Natriuretic Peptide as an Indicator of Possible Cardiovascular Disease in Severely Obese Individuals: Comparison with Patients in Different Stages of Heart Failure

Katharina-Maria Hermann-Arnhof1,a, Ursula Hanusch-Enserer4, Thomas Kaestenbauer2, Thomas Publig3, Attila Dunky4, Harald R. Rosen5, Rudolf Prager2 and Ursula Köller1

1 Department for Clinical and Chemical Laboratory Diagnostic, 2 Ludwig Bolzmann Institute for Metabolic Diseases and Nutrition and Department of Internal Medicine III, Division of Metabolic Diseases and Nephrology, and 3 Department of Internal Medicine IV, Division of Cardiology, Hospital Lainz, Vienna, Austria.
4 Department of Internal Medicine V, Division of Diabetology and Rheumatology, Wilhelminenspital, Vienna, Austria.
5 Department of Surgery, SMZO, Vienna, Austria.

aAddress correspondence to this author at: Institute for Medical and Chemical Laboratory Diagnostics, Hospital Lainz, Wolkersbergenstrasse 1, 1130 Vienna, Austria. Fax 43-1-80110/2688; e-mail katharina.hermann{at}wienkav.at.

Background: Mild stages of heart failure might be difficult to diagnose in severely obese individuals with a body mass index (BMI) >40 kg/m2. Measurement of the N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) is feasible for detecting cardiac impairment. The aims of our study were to measure NT-proBNP in plasma of severely obese patients and to compare the results with results for patients in different stages of manifest cardiac dysfunction.

Methods: In 61 severely obese individuals (median BMI, 43.2 kg/m2) and 96 nonobese patients with existing heart failure [classified into New York Heart Association (NYHA) classes I–IV], NT-proBNP was measured in the fasting condition. A medical history, physical examination, electrocardiography, blood chemistry, and chest x-ray were performed in the obese group. In addition, echocardiography was performed in the NYHA group.

Results: In obese individuals, NT-proBNP was increased to a median of 356 (interquartile range, 221–458) pmol/L [854 (530–1099) ng/L] and was comparable (P >0.05) to the median value for NYHA I patients {289 (258–451) pmol/L [694 (619–1082) ng/L]}, but was significantly lower than in the other NYHA groups (P <0.001 for each).

Conclusion: The prognostic relevance of increased NT-proBNP for risk of developing cardiac insufficiency in severely obese patients needs to be further evaluated.




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