IRCCS Neuromed, Polo Molisano University Sapienza of Rome, Pozzilli Is, Rome, Italy. rubattu.speranza neuromed.it
J Hypertens. 2010 Aug;28(8):1638-45. doi: 10.1097/HJH.0b013e32833a39aa.
Natriuretic peptides control cardiovascular functions through diuretic, natriuretic, and vasodilatory properties. Several anthropometric, cardiac and renal variables were found to be independently correlated to their levels. Few studies, however, systematically investigated the independent determinants of natriuretic peptide levels in large populations.
The present analysis was carried out in a large unselected sample of adult male population in Southern Italy (The Olivetti Heart Study, n = 806 men, mean age = 59.5, range 35-82 years). We examined the relationship of plasma natriuretic peptide-proatrial natriuretic peptide (NT-proANP) levels with relevant anthropometric, clinical and biochemical variables; the impact of age; and the association of NT-proANP levels with cardiovascular risk.
NT-proANP was directly associated to age, pulse pressure (PP), renal sodium fractional excretion (FENa) (P < 0.005), and inversely to diastolic blood pressure (DBP), heart rate (HR), creatinine clearance, body mass index (BMI), arm and leg circumferences (P < 0.005). After adjustment for age, DBP, creatinine clearance, FENa and HR remained independent determinants of NT-proANP levels (all P < 0.01, cumulative R = 0.186). Upon stratification of our population by tertile of age, NT-proANP was significantly associated (P <or= 0.01) to arm circumference in the lowest age tertile (mean age 53.8 years), and to FENa, DBP and creatinine clearance in the highest tertile (mean age 66.7 years). A direct significant association between NT-proANP levels and cardiovascular risk score, estimated by two independent algorithms, was observed (P < 0.001).
Anthropometric, cardiovascular and renal factors exerted a different impact on NT-proANP levels at different ages in our study population. Higher NT-proANP levels were associated with increased cardiovascular risk.
利钠肽通过利尿、利钠和血管舒张作用来控制心血管功能。多项人体测量学、心脏和肾脏变量已被证实与利钠肽水平独立相关。然而，很少有研究系统地调查了在大人群中利钠肽水平的独立决定因素。
本分析在意大利南部的一个大型未选择的成年男性人群中进行（奥利维蒂心脏研究，n=806 名男性，平均年龄 59.5 岁，范围 35-82 岁）。我们检查了血浆利钠肽-前利钠肽（NT-proANP）水平与相关人体测量学、临床和生化变量的关系；年龄的影响；以及 NT-proANP 水平与心血管风险的关联。
NT-proANP 与年龄、脉压（PP）、肾钠分数排泄（FENa）呈直接相关（P＜0.005），与舒张压（DBP）、心率（HR）、肌酐清除率、体重指数（BMI）、臂围和腿围呈负相关（P＜0.005）。在调整年龄、DBP、肌酐清除率、FENa 和 HR 后，NT-proANP 水平仍然是独立的决定因素（均 P＜0.01，累积 R=0.186）。根据年龄三分位分层，NT-proANP 在年龄最低三分位（平均年龄 53.8 岁）与臂围显著相关（P＜0.01），在年龄最高三分位（平均年龄 66.7 岁）与 FENa、DBP 和肌酐清除率显著相关。NT-proANP 水平与通过两种独立算法估计的心血管风险评分之间存在直接显著关联（P＜0.001）。
在我们的研究人群中，人体测量学、心血管和肾脏因素在不同年龄对 NT-proANP 水平产生不同的影响。较高的 NT-proANP 水平与增加的心血管风险相关。
