Computerized tomography measured liver fat is associated with low levels of N-terminal pro-brain natriuretic protein (NT-proBNP). Multi-Ethnic Study of Atherosclerosis

Otto A Sanchez; Mariana Lazo-Elizondo; Irfan Zeb; Russell P Tracy; Ryan Bradley; Daniel A Duprez; Hossein Bahrami; Carmen A Peralta; Lori B Daniels; João A Lima; Alan Maisel; David R Jacobs Jr; Mathew J Budoff

doi:10.1016/j.metabol.2016.02.001

Computerized tomography measured liver fat is associated with low levels of N-terminal pro-brain natriuretic protein (NT-proBNP). Multi-Ethnic Study of Atherosclerosis

Metabolism. 2016 May;65(5):728-735. doi: 10.1016/j.metabol.2016.02.001. Epub 2016 Feb 27.

Authors

Affiliations

¹ Department of Internal Medicine, Division of Renal Diseases and Hypertension, University of Minnesota, 717 Delaware, Mail Code 1932, Minneapolis, MN 55414. Electronic address: sanc0050@umn.edu.
² Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: mlazo@jhu.edu.
³ Department of Cardiology, Mount Sinai St. Luke's Roosevelt Hospital (Bronx-Lebanon Hospital Center). Electronic address: izeb82@gmail.com.
⁴ University of Vermont College of Medicine, Burlington, VT 05405. Electronic address: russell.tracy@uvm.edu.
⁵ National College of Natural Medicine, SW Porter Street, Portland, OR 97201. Electronic address: rbradley@ncnm.edu.
⁶ Division of Cardiology, University of Minnesota, 420 Delaware St. SE. Mayo Mail Code 508, Minneapolis, MN 55455. Electronic address: dupre007@umn.edu.
⁷ Stanford Cardiovascular Institute, Stanford University. Electronic address: hbahrami@stanford.edu.
⁸ School of Medicine, University of California San Francisco, 33 Parnassus Ave, UC Hall, San Francisco, CA 94143. Electronic address: CarmenAlicia.Peralta@ucsf.edu.
⁹ Division of Cardiology, University of California, San Diego, Sulpizio Cardiovascular Center, 9434 Medical Center Drive, La Jolla, CA 92037. Electronic address: lbdaniels@ucsd.edu.
¹⁰ Division of Cardiology, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224. Electronic address: jlima@jhmi.edu.
¹¹ School of Medicine, University of California, 3350 La Jolla Village Drive, Cardiology Section, mc 9111A, San Diego, CA 92161. Electronic address: amaisel@ucsd.edu.
¹² School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN. Electronic address: jacob004@umn.edu.
¹³ Los Angeles Biomedical Research Institute, Division of Cardiology, Harbor-UCLA Medical Center, Los Angeles, CA. Electronic address: mbudoff@labiomed.org.

Abstract

Background and aims: N-terminal pro B-type natriuretic peptide (NT-proBNP) is inversely associated with diabetes mellitus, obesity and metabolic syndrome. We aim to characterize the association between NT-proBNP and nonalcoholic fatty liver disease (NAFLD), a condition strongly associated with metabolic syndrome.

Methods: 4529 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) free of cardiovascular disease, without self-reported liver disease and not diabetic at their baseline visit in 2000-2002 were included in this analysis. NAFLD was defined by a liver attenuation <40 HU. Relative prevalence (RP) for NAFLD was assessed adjusted for age, race, and sex, percentage of dietary calories derived from fat, total intentional exercise, alcoholic drinks per week, and interleukin-6 by quintiles of NT-proBNP. Adjusted linear spline model was used to characterize a non-linear association between NT-proBNP and liver fat. The inflection point (IP) was the NT-proBNP concentration where there was a change in slope in the association between liver attenuation and NT-proBNP.

Results: RP for NAFLD decreased by 30% from the lowest to the highest quintile of NT-proBNP, p=0.01. We observed an inverse linear association between NT-proBNP and liver fat, which plateaued (IP) at an NT-proBNP concentration of 45pg/mL. Linear regression coefficient (SE) per unit of NT-proBNP less than and greater than or equal to IP was of 0.05 (0.02), p=0.001 and 0.0006 (0.0008), p=0.5, respectively; differences between slopes, p<0.0001.

Conclusions: In this cross-sectional study of a community based multiethnic sample of non-diabetic adults, low levels of NT-proBNP are associated with greater prevalence of NAFLD.

Keywords: Hounsfield units; NT-proBNP; Natriuretic peptides; Non-alcohol fatty liver disease.

Publication types

Multicenter Study
Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Aged
Aged, 80 and over
Asymptomatic Diseases / epidemiology
Biomarkers / blood
Cohort Studies
Cross-Sectional Studies
Down-Regulation*
Female
Humans
Linear Models
Lipid Metabolism*
Liver / diagnostic imaging
Liver / metabolism*
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Non-alcoholic Fatty Liver Disease / blood
Non-alcoholic Fatty Liver Disease / diagnostic imaging
Non-alcoholic Fatty Liver Disease / epidemiology
Non-alcoholic Fatty Liver Disease / metabolism*
Peptide Fragments / blood*
Prevalence
Risk Factors
Tomography, X-Ray Computed
United States / epidemiology

Substances

Biomarkers
Peptide Fragments
pro-brain natriuretic peptide (1-76)
Natriuretic Peptide, Brain

Abstract

Publication types

MeSH terms

Substances

Grants and funding