Department of Cardiology, Skane University Hospital, Malmö, Sweden.
Scand Cardiovasc J. 2011 Oct;45(5):294-300. doi: 10.3109/14017431.2011.581763. Epub 2011 May 23.
Glucometabolic disturbances are associated with myocardial dysfunction. Brain natriuretic peptides (BNP) are used for detecting myocardial dysfunction in clinical practice. However, studies on elderly subjects and gender-specific analyses are sparse.
We examined cross-sectional associations between Nt-proBNP and 1) fasting plasma glucose (FPG), and 2) categories of glucometabolic disturbances, in middle-aged and older subjects (1266 men, 526 women), applying multivariate linear regression analysis.
FPG was positively correlated with Nt-proBNP among middle-aged men (p = 0.04) and negatively albeit non-significantly (p = 0.1) among middle-aged women. Weaker non-significant correlations were seen among older subjects. Middle-aged men with new-onset and prevalent diabetes had higher Nt-proBNP than the reference group (FPG ≤5.0 mmol/L): 9.53 (p = 0.002) and 8.23 (p = 0.02) vs. 5.71 pmol/L. No differences in Nt-proBNP between categories of glucometabolic disturbance were observed among older men or women.
The results indicate an age- and gender difference in the ability of Nt-proBNP to identify myocardial dysfunction in relation to glucometabolic disturbances. Therefore, Nt-proBNP should be used with caution as a general surrogate marker for myocardial dysfunction in this setting.
糖代谢紊乱与心肌功能障碍有关。脑钠肽（BNP）用于临床检测心肌功能障碍。然而，针对老年患者和性别特异性的研究较为缺乏。
我们应用多元线性回归分析，在中年和老年受试者（男性 1266 人，女性 526 人）中，检验了 Nt-proBNP 与 1）空腹血糖（FPG）和 2）糖代谢紊乱类别之间的横断面关联。
FPG 与中年男性的 Nt-proBNP 呈正相关（p=0.04），而在中年女性中则呈负相关（p=0.1），但无统计学意义。在老年受试者中，相关性较弱且无统计学意义。新发和现患糖尿病的中年男性的 Nt-proBNP 高于参考组（FPG≤5.0mmol/L）：9.53（p=0.002）和 8.23（p=0.02）vs. 5.71pmol/L。老年男性或女性中，各糖代谢紊乱类别的 Nt-proBNP 之间无差异。
结果表明，Nt-proBNP 识别糖代谢紊乱相关心肌功能障碍的能力存在年龄和性别差异。因此，在这种情况下，Nt-proBNP 作为心肌功能障碍的一般替代标志物应谨慎使用。
