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Cardiovascular hormone linked to risk for diabetes

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B-type natriuretic peptide levels may play a role in decreasing a person's risk for type 2 diabetes, according to researchers in the United Kingdom.

The hormone B-type natriuretic peptide (BNP) helps maintain cardiovascular function by mediating vasodilation, natriuresis and antifibrotic effects, the researchers said in a study published online in PLoS Medicine. The hormone, however, also has lipolytic activity, and cross-sectional studies indicate that people with obesity, insulin resistance and type 2 diabetes have decreased levels of BNP or the inactive fragment of its pro-hormone, N-terminal fragment of pro-BNP (NT-proBNP).

To further investigate the connection between NT-proBNP in blood and type 2 diabetes, the researchers performed a prospective case-cohort study of three case-control studies involving patients with type 2 diabetes. They also genotyped the variant rs198389 within the BNP locus and included their results in a meta-analysis of 11 case-control studies.

A multivariable analysis of data from the researchers' case-cohort study suggested that every increase of one standard deviation (SD) in log-transformed NT-proBNP levels correlated with a 21% reduced risk for type 2 diabetes (HR=0.79; 95% CI, 0.64-0.97). Results were adjusted for age; sex; BMI; systolic blood pressure; smoking status; family history of type 2 diabetes; history of hypertension; and HDL, LDL and triglyceride levels.

"The association between rs198389 and type 2 diabetes observed in case-control studies (OR=0.94 per C allele; 95% CI, 0.91-0.97) was similar to that expected (OR=0.96; 95% CI, 0.93-0.98) based on the pooled estimate for the log-NT-proBNP level to type 2 diabetes association derived from a meta-analysis of our study and published data (HR=0.82 per SD; 95% CI, 0.74-0.9) and the difference in NT-proBNP levels (HR=0.22 per SD; 95% CI, 0.15-0.29) per C allele of rs198389," the researchers said.

Data also suggested no relationship between the rs198389 genotype and potential confounders, according to the researchers.

"The evidence for a potential causal link between the BNP hormone system and type 2 diabetes also promotes BNP as a potentially interesting target of preventive interventions. Influencing BNP activity by pharmaceutical interventions has been proven to be feasible in the context of CV medicine," they said.

They concluded, however, that further research into BNP and the etiology of type 2 diabetes is needed.

For more information:

• Pfister R. PLoS Med. 2011;doi:10.1371/journal.pmed.1001112.

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