Huang Fang-Yang, Peng Yong, Deng Xue-Xue, Huang Bao-Tao, Xia Tian-Li, Gui Yi-Yue, Liu Rui-Shuang, Yang Yong, Pu Xiao-Bo, Chen Shi-Jian, Chen Fei, Zhu Ye, Chen Mao
Departments of aCardiology bGeneral Practice Medicine, West China Hospital, Sichuan University, Chengdu, China.
Coron Artery Dis. 2017 Mar;28(2):159-165. doi: 10.1097/MCA.0000000000000464.
Our aim was to investigate whether the presence of metabolic syndrome (MetS) and diabetes mellitus (DM) influenced the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and its prognostic performance in coronary artery disease (CAD).
The present study enrolled a total of 1638 CAD patients. Multivariate regression analyses were carried out to relate NT-proBNP to metabolic components, nondiabetic MetS, DM, and MetS score. Furthermore, we examined the prognostic performance of NT-proBNP in patients with non-MetS, nondiabetic MetS, and DM.
NT-proBNP levels correlated inversely with BMI (β=-0.11, P=0.003) and correlated positively with fasting glucose (β=0.12, P=0.001). There were no significant relationships of NT-proBNP with other metabolic parameters. Compared with non-MetS, the presence of DM significantly increased NT-proBNP levels (P=0.004), whereas nondiabetic MetS did not influence NT-proBNP levels (P=0.954). During the median follow-up of 21 months, 109 all-cause deaths occurred. NT-proBNP levels independently predicted all-cause deaths irrespective of the presence of nondiabetic MetS and DM (Pinteraction=0.43).
DM, but not nondiabetic MetS, is associated with higher NT-proBNP levels. NT-proBNP can still predict death in patients with CAD, even with the confounding effect of MetS and diabetes.
我们的目的是研究代谢综合征（MetS）和糖尿病（DM）的存在是否会影响冠状动脉疾病（CAD）患者的N端前脑钠肽（NT-proBNP）水平及其预后性能。
本研究共纳入1638例CAD患者。进行多变量回归分析，以探讨NT-proBNP与代谢成分、非糖尿病性MetS、DM及MetS评分之间的关系。此外，我们还研究了NT-proBNP在非MetS、非糖尿病性MetS和DM患者中的预后性能。
NT-proBNP水平与体重指数呈负相关（β=-0.11，P=0.003），与空腹血糖呈正相关（β=0.12，P=0.001）。NT-proBNP与其他代谢参数之间无显著相关性。与非MetS相比，DM的存在显著增加了NT-proBNP水平（P=0.004），而非糖尿病性MetS对NT-proBNP水平无影响（P=0.954）。在21个月的中位随访期内，发生了109例全因死亡。无论是否存在非糖尿病性MetS和DM，NT-proBNP水平均可独立预测全因死亡（P交互作用=0.43）。
DM而非非糖尿病性MetS与较高的NT-proBNP水平相关。即使存在MetS和糖尿病的混杂效应，NT-proBNP仍可预测CAD患者的死亡。
