Pearson Andree G, Pearson John F, Lewis Lynley K, Fa'atoese Allamanda, Poppe Katrina K, Pemberton Chris, Devlin Gerry, Lund Mayanna, Richards A Mark, Troughton Richard, Doughty Robert N
Christchurch Heart Institute, Department of Medicine, University of Otago, Christchurch, New Zealand.
Department of Medicine Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
ESC Heart Fail. 2025 Aug;12(4):2976-2984. doi: 10.1002/ehf2.15314. Epub 2025 Apr 28.
Plasma concentrations of the heart failure (HF) biomarker N-terminal B-type natriuretic peptide (NT-proBNP) vary by ethnicity. We investigated whether NT-proBNP concentrations differed in HF between Pacific peoples, Māori (the Indigenous people), and New Zealand (NZ) Europeans, in patients with HF.
Plasma NT-proBNP was measured in patients with HF participating in two prospective NZ based multicentre studies [PEOPLE: n = 836, 30% female, median age 71, interquartile interval (IQI) 60, 80; IMPERATIVE-HF: n = 413, 30% female, median age 66, IQI 55, 76]. Regression analyses were used to understand predictors of NT-proBNP taking into account age, sex, body mass index (BMI), estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF) and presence of atrial fibrillation (AF).
Median NT-proBNP concentrations were significantly lower in both Pacific (930 pg/mL; P < 0.001, IQI 409-1,473; n = 127) and Māori (1,387 pg/mL, IQI 685-2,393; P < 0.001; n = 221) compared with NZ Europeans (2,055 pg/mL, IQI 973-3,865; n = 901) in unadjusted comparisons. NT-proBNP was independently associated with ethnicity, age, sex, BMI, eGFR, LVEF and presence of AF. The significant differences in plasma NT-proBNP between Pacific peoples, but not Māori, and NZ Europeans remained after adjusting for these clinical and demographic factors. The effect of age on NT-proBNP concentrations differed significantly between Pacific peoples and NZ Europeans, but not between Māori and NZ European (P = 0.0109). For each decade of life over 60 years, plasma NT-proBNP in patients with HF was on average, 67% lower in a Pacific person than that of an aged-matched NZ European.
In HF, Pacific and Māori people had significantly lower median plasma concentrations of NT-proBNP than NZ Europeans. This difference remained after adjusting for clinical and demographic factors in patients with Pacific ethnicity. Pacific peoples also had a significantly lower rate of increase of NT-proBNP with age compared with NZ Europeans and Māori.
心力衰竭（HF）生物标志物N端B型利钠肽原（NT-proBNP）的血浆浓度因种族而异。我们调查了太平洋岛民、毛利人（原住民）和新西兰（NZ）欧洲裔心力衰竭患者的NT-proBNP浓度是否存在差异。
在参与两项基于新西兰的前瞻性多中心研究的心力衰竭患者中测量血浆NT-proBNP[PEOPLE研究：n = 836，女性占30%，中位年龄71岁，四分位间距（IQI）为60, 80；IMPERATIVE-HF研究：n = 413，女性占30%，中位年龄66岁，IQI为55, 76]。采用回归分析来了解NT-proBNP的预测因素，同时考虑年龄、性别、体重指数（BMI）、估计肾小球滤过率（eGFR）、左心室射血分数（LVEF）和房颤（AF）的存在情况。
在未经调整的比较中，太平洋岛民（930 pg/mL；P < 0.001，IQI 409 - 1,473；n = 127）和毛利人（1,387 pg/mL，IQI 685 - 2,393；P < 0.001；n = 221）的NT-proBNP中位浓度均显著低于新西兰欧洲裔（2,055 pg/mL，IQI 973 - 3,865；n = 901）。NT-proBNP与种族、年龄、性别、BMI、eGFR、LVEF和房颤的存在独立相关。在调整这些临床和人口统计学因素后，太平洋岛民与新西兰欧洲裔之间血浆NT-proBNP仍存在显著差异，但毛利人与新西兰欧洲裔之间不存在显著差异。太平洋岛民和新西兰欧洲裔之间年龄对NT-proBNP浓度的影响存在显著差异，但毛利人和新西兰欧洲裔之间不存在显著差异（P = 0.0109）。对于60岁以上的每十年，心力衰竭患者中太平洋岛民的血浆NT-proBNP平均比年龄匹配的新西兰欧洲裔低67%。
在心力衰竭患者中，太平洋岛民和毛利人的NT-proBNP血浆中位浓度显著低于新西兰欧洲裔。在调整太平洋岛民患者的临床和人口统计学因素后，这种差异仍然存在。与新西兰欧洲裔和毛利人相比，太平洋岛民的NT-proBNP随年龄增长的速率也显著更低。
