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This Article Full Text Full Text (PDF) 084426.Supplemental Data All Versions of this Article: clinchem.2006.084426v1 53/11/1928    most recent Submit an electronic Letter to the Editor about this paper Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Schou, M. Articles by Hildebrandt, P. R. Search for Related Content PubMed PubMed Citation Articles by Schou, M. Articles by Hildebrandt, P. R. Related Collections Proteomics and Protein Markers Endocrinology and Metabolism

Effects of Body Mass Index and Age on N-Terminal Pro–Brain Natriuretic Peptide Are Associated with Glomerular Filtration Rate in Chronic Heart Failure Patients

¹ Department of Cardiology and Endocrinology, Clinic E, Frederiksberg University Hospital, Frederiksberg, Denmark.
Departments of² Cardiology, The Heart Centre, and³ Clinical Physiology and Nuclear Medicine, The PET Centre, Rigshospitalet University Hospital, Copenhagen, Denmark.
⁴ Cluster for Molecular Imaging, University of Copenhagen, Copenhagen, Denmark.
⁵ Department of Cardiology, Roskilde University Hospital, Roskilde, Denmark.

^aAddress correspondence to this author at: Department of Cardiology and Endocrinology, Clinic E, Frederiksberg University Hospital, Ndr. Fasanvej 57-59, DK-2000 Frederiksberg, Denmark. Fax 45-38-16-43-59; e-mail m.schou{at}dadlnet.dk.

Background: Obesity is a state characterized by glomerular hyperfiltration and age-related decreases in glomerular filtration rate (GFR). Body mass index (BMI), age, and GFR are associated with plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) in chronic heart failure (CHF) patients. We hypothesized that the effects of BMI and age on plasma concentrations of NT-proBNP are associated with GFR.

Methods: We obtained clinical data and laboratory test results from 345 CHF patients at the baseline visit in our heart failure clinic and examined the hypothesis using multiple linear regression models.

Results: Age (P = 0.0184), BMI (P = 0.0098), hemoglobin (P = 0.0043), heart rhythm (P <0.0001), and left ventricular ejection fraction (P <0.0001) were associated with log(NT-proBNP). After adjustment for GFR estimated by the Cockcroft and Gault equation, the parameter estimates for BMI (P = 0.3807) and age (P = 0.7238) changed markedly and became insignificant. In another model, after adjustment for GFR estimated by the 4-component Modification of Diet in Renal Disease formula (eGFR_MDRD), the parameter estimates for age (P = 0.0674) changed markedly and became insignificant, but BMI (P = 0.0067) remained significant and unchanged. The eGFR_MDRD is adjusted for body surface area, which may explain the difference.

Conclusions: In CHF patients, the effect of age on NT-proBNP is associated with estimates for GFR derived from serum creatinine, and the significance of the effects of BMI on NT-proBNP depends on the method by which GFR is estimated.