Hasegawa Takuya, Asakura Masanori, Eguchi Kazuo, Asanuma Hiroshi, Ohara Takahiro, Kanzaki Hideaki, Hashimura Kazuhiko, Tomoike Hitonobu, Kim Jiyoong, Kitakaze Masafumi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Department of Cardiology, International University of Health and Welfare Hospital, Nasushiobara, Japan.
Hypertens Res. 2015 Jan;38(1):74-9. doi: 10.1038/hr.2014.123. Epub 2014 Aug 14.
B-type natriuretic peptide (BNP) has been reported to be associated with cardiovascular prognosis in a community-based population. In addition, accumulation of individual cardiovascular risk factors is important in predicting an individual's risk of future cardiovascular disease. However, there have been few reports showing that BNP is a comprehensive marker of the accumulation of cardiovascular risk factors. We studied 1530 community-dwelling subjects without obvious heart diseases or renal dysfunction (mean age 62 ± 15 years; 569 men and 961 women) who participated in an annual health checkup in a rural Japanese community. Coronary heart disease (CHD) risk was estimated, and patients were placed into the following three groups based on the Framingham function: low risk, moderate risk and high risk. The prevalence of moderate- and high-risk subjects for CHD rose in both genders with increasing plasma BNP levels. The area under the receiver operating characteristic curve showed a modest ability of plasma BNP levels to detect these subjects (0.755 and 0.700 for men and women, respectively). The optimal thresholds for the identification of subjects with moderate- and high-risk disease were BNP concentrations of 12.0 and 22.0 pg ml(-1), with sensitivities of 70% and 66% and specificities of 71% and 63% for men and women, respectively. In conclusion, subjects with high plasma BNP levels were at higher risk for CHD in a population without obvious heart disease or renal dysfunction.
据报道，B型利钠肽（BNP）与社区人群的心血管预后相关。此外，个体心血管危险因素的累积对于预测个体未来患心血管疾病的风险很重要。然而，鲜有报道表明BNP是心血管危险因素累积的综合标志物。我们研究了1530名居住在社区、无明显心脏病或肾功能不全的受试者（平均年龄62±15岁；男性569名，女性961名），这些受试者参与了日本农村社区的年度健康检查。评估了冠心病（CHD）风险，并根据弗雷明汉函数将患者分为以下三组：低风险、中度风险和高风险。随着血浆BNP水平升高，男性和女性中CHD中度和高风险受试者的患病率均上升。受试者工作特征曲线下面积显示血浆BNP水平检测这些受试者的能力一般（男性和女性分别为0.755和0.700）。识别中度和高风险疾病受试者的最佳阈值分别为BNP浓度12.0和22.0 pg/ml（-1），男性和女性的敏感性分别为70%和66%，特异性分别为71%和63%。总之，在无明显心脏病或肾功能不全的人群中，血浆BNP水平高的受试者患CHD的风险更高。
