Diabetologia

, Volume 57, Issue 5, pp 935–939

Circulating natriuretic peptide concentrations reflect changes in insulin sensitivity over time in the Diabetes Prevention Program

  • Geoffrey A. Walford
  • Yong Ma
  • Costas A. Christophi
  • Ronald B. Goldberg
  • Petr Jarolim
  • Edward Horton
  • Kieren J. Mather
  • Elizabeth Barrett-Connor
  • Jaclyn Davis
  • Jose C. Florez
  • Thomas J. Wang
  • for the Diabetes Prevention Program Research Group
Short Communication

DOI: 10.1007/s00125-014-3183-2

Cite this article as:
Walford, G.A., Ma, Y., Christophi, C.A. et al. Diabetologia (2014) 57: 935. doi:10.1007/s00125-014-3183-2

Abstract

Aims/hypothesis

We aimed to study the relationship between measures of adiposity, insulin sensitivity and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the Diabetes Prevention Program (DPP).

Methods

The DPP is a completed clinical trial. Using stored samples from this resource, we measured BMI, waist circumference (WC), an insulin sensitivity index (ISI; [1/HOMA-IR]) and NT-proBNP at baseline and at 2 years of follow-up in participants randomised to placebo (n = 692), intensive lifestyle intervention (n = 832) or metformin (n = 887).

Results

At baseline, log NT-proBNP did not differ between treatment arms and was correlated with baseline log ISI (p < 0.0001) and WC (p = 0.0003) but not with BMI (p = 0.39). After 2 years of treatment, BMI decreased in the lifestyle and metformin groups (both p < 0.0001); WC decreased in all three groups (p < 0.05 for all); and log ISI increased in the lifestyle and metformin groups (both p < 0.001). The change in log NT-proBNP did not differ in the lifestyle or metformin group vs the placebo group (p > 0.05 for both). In regression models, the change in log NT-proBNP was positively associated with the change in log ISI (p < 0.005) in all three study groups after adjusting for changes in BMI and WC, but was not associated with the change in BMI or WC after adjusting for changes in log ISI.

Conclusion/interpretation

Circulating NT-proBNP was associated with a measure of insulin sensitivity before and during preventive interventions for type 2 diabetes in the DPP. This relationship persisted after adjustment for measures of adiposity and was consistent regardless of whether a participant was treated with placebo, intensive lifestyle intervention or metformin.

Keywords

Diabetes prevention Insulin sensitivity Natriuretic peptides NT-proBNP Obesity 

Abbreviations

BNP

B-type natriuretic peptide

DPP

Diabetes Prevention Program

ISI

Insulin sensitivity index

IPW

Inverse probability weighting

NT-proBNP

N-terminal pro-B-type natriuretic peptide

WC

Waist circumference

Supplementary material

125_2014_3183_MOESM1_ESM.pdf (112 kb)
ESM Research Group List(PDF 112 kb)

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Geoffrey A. Walford
    • 1
    • 2
    • 3
    • 4
  • Yong Ma
    • 4
  • Costas A. Christophi
    • 4
  • Ronald B. Goldberg
    • 4
    • 5
  • Petr Jarolim
    • 6
  • Edward Horton
    • 2
    • 4
    • 7
  • Kieren J. Mather
    • 4
    • 8
  • Elizabeth Barrett-Connor
    • 4
    • 9
    • 10
  • Jaclyn Davis
    • 3
    • 4
  • Jose C. Florez
    • 1
    • 2
    • 3
    • 4
  • Thomas J. Wang
    • 11
  • for the Diabetes Prevention Program Research Group
  1. 1.Diabetes Research Center (Diabetes Unit)Massachusetts General HospitalBostonUSA
  2. 2.Department of MedicineHarvard Medical SchoolBostonUSA
  3. 3.Center for Human Genetic ResearchMassachusetts General HospitalBostonUSA
  4. 4.Diabetes Prevention Program Data Coordinating Center, The Biostatistics CenterGeorge Washington UniversityRockvilleUSA
  5. 5.Division of Endocrinology, Diabetes, and MetabolismUniversity of Miami Miller School of MedicineMiamiUSA
  6. 6.Division of Clinical Laboratories, Department of PathologyBrigham and Women’s HospitalBostonUSA
  7. 7.Joslin Diabetes CenterBostonUSA
  8. 8.Division of EndocrinologyIndiana University School of MedicineIndianapolisUSA
  9. 9.Department of Family and Preventive MedicineUniversity of California, San Diego School of MedicineLa JollaUSA
  10. 10.Department of MedicineUniversity of California, San Diego School of MedicineLa JollaUSA
  11. 11.Division of CardiologyVanderbilt University Medical CenterNashvilleUSA

Personalised recommendations