Shetty Naman S, Gaonkar Mokshad, Patel Nirav, Vekariya Nehal, Yerabolu Krishin, Dhaliwal Jasninder S, Buford Thomas W, Gower Barbara, Li Peng, Wang Thomas J, Arora Garima, Arora Pankaj
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Nat Commun. 2025 Feb 13;16(1):1621. doi: 10.1038/s41467-024-55648-2.
Black individuals have lower plasma natriuretic peptide (NP) concentrations than white individuals. However, race-based differences in the NP response to physiological perturbations are unknown. In this physiological trial (NCT#03070184), we measured the NP [mid-regional atrial NP (MR-proANP), N-terminal pro-B-type NP (NT-proBNP), and BNP] response to physiological perturbations among healthy, self-identified Black and white participants aged 18-40 years. The primary and secondary outcomes were the change in plasma NP concentrations at 6 weeks after metoprolol (initiated at 50 mg/day and doubled every 2 weeks) and standardized, aerobic exercise (70% of their maximal oxygen uptake on a salt-standardized background), respectively. Among 40 Black [median age: 27 (22, 32) years; 21 (52.5%) women] and 40 white [median age: 25 (20, 30) years; 19 (47.5%) women] participants, exercise increased MR-proANP (Black: 35%; white: 43%), NT-proBNP (Black: 11%; white: 23%), and BNP (Black: 59%; white: 61%) in both self-reported races. Exercise was associated with an increase in plasma MR-proANP (p: 0.25) and BNP (p: 0.87) concentrations which did not vary by self-reported race. However, the increase in plasma NT-proBNP concentrations were higher in white participants than in Black participants. (p: 0.04) Similarly, metoprolol therapy increased MR-proANP (Black: 18%; white: 16%), NT-proBNP (Black: 95%; white: 99%), and BNP (Black: 45%; white: 74%) in both self-reported races. The metoprolol-associated increase in plasma MR-proANP (p: 0.85), NT-proBNP (p: 0.94), and BNP (p: 0.21) concentrations were similar by self-reported race. In conclusion, the higher increase in plasma NT-proBNP concentrationsamong white patients after exercise suggests that exercise may induce significant physiological variations in NP levels. ClinicalTrials.gov ID: NCT03070184.
黑人个体的血浆利钠肽（NP）浓度低于白人个体。然而，NP对生理扰动的反应在种族间的差异尚不清楚。在这项生理学试验（NCT#03070184）中，我们测量了年龄在18至40岁之间、自我认定为黑人或白人的健康参与者对生理扰动的NP[中段心房利钠肽（MR-proANP）、N端前脑钠肽（NT-proBNP）和脑钠肽（BNP）]反应。主要和次要结局分别是美托洛尔（起始剂量为50mg/天，每2周加倍）和标准化有氧运动（在盐标准化背景下达到其最大摄氧量的70%）6周后血浆NP浓度的变化。在40名黑人参与者[中位年龄：27（22，32）岁；21名（52.5%）为女性]和40名白人参与者[中位年龄：25（20，30）岁；19名（47.5%）为女性]中，运动使自我报告的两个种族的MR-proANP（黑人：35%；白人：43%）、NT-proBNP（黑人：11%；白人：23%）和BNP（黑人：59%；白人：61%）均升高。运动与血浆MR-proANP（p：0.25）和BNP（p：0.87）浓度升高相关，且不因自我报告的种族而有所不同。然而，白人参与者血浆NT-proBNP浓度的升高高于黑人参与者（p：0.04）。同样，美托洛尔治疗使自我报告的两个种族的MR-proANP（黑人：18%；白人：16%）、NT-proBNP（黑人：95%；白人：99%）和BNP（黑人：45%；白人：74%）均升高。美托洛尔相关的血浆MR-proANP（p：0.85）、NT-proBNP（p：0.94）和BNP（p：0.21）浓度升高在自我报告的种族间相似。总之，运动后白人患者血浆NT-proBNP浓度升高幅度更大，提示运动可能诱导NP水平出现显著的生理差异。ClinicalTrials.gov标识符：NCT03070184。
