N-terminal fragment of probrain natriuretic peptide is associated with diabetes microvascular complications in type 2 diabetes

Figures & data

Table 1 Characteristics of subjects with and without diabetic complications

	Case subjects*	Control subjects	P
Number	217	60
Age (years)	63.4±12.0	54.1±13.6	<0.0001
Diabetes duration (years)	9 (3–17)	4 (1–11)	0.0029
Males (%)	60.8%	70.0%	0.1933
BMI (kg/m^2)	26.3±4.9	25.9±5.3	0.5466
HbA1c (%)	8.7±2.0 (71.6)	8.5±2.3 (69.4)	0.4404
SBP (mmHg)	136.4±19.6	130.3±16.8	0.0270
DBP (mmHg)	79.0±12.5	77.7±10.4	0.4525
Total cholesterol (mg/dL)	195.1±37.9	199.0±49.8	0.5918
LDL cholesterol (mg/dL)	117.2±33.6	122.8±37.7	0.2733
HDL cholesterol (mg/dL)	55.1±16.1	56.9±17.3	0.4528
Triglycerides (mg/dL)	140 (104–214)	151 (107–231)	0.7500
NT-proBNP (pg/mL)	59 (26–140)	33 (16–58)	<0.0001
Smoking (%)	24.2%	24.4%	0.5040
Albuminuria (μg/min)	24.9 (9.0–92.8)	8.2 (5.4–15.7)	<0.0001
IMTR	1,788±431	1,504±301	<0.0001
IMTL	1,813±568	1,522±303	0.0003
PWVR	1.12±0.14	1.14±0.08	0.4128
PWVL	1.11±0.14	1.14±0.09	0.0939
ABIR	2.61±0.87	2.49±0.65	0.3652
ABIL	71.6±23.5	79.8±20.4	0.0147

Notes: Data are mean ± SD.

* Presence of any of diabetic complications (DMR, nephropathy, DSN, CVD, and PAD). P-values in bold were demonstrated to have adequate effect size.

Abbreviations: BMI, body mass index; HbA_1c, hemoglobin A_1c; SBP, systolic blood pressure; DBP, diastolic blood pressure; LDL, low-density lipoprotein; HDL, high-density lipoprotein; NT-proBNP, N-terminal fragment of probrain natriuretic peptide; IMTL, intima media thickness of left carotid; IMTR, intima media thickness of right carotid; PWV, pulse wave velocity; ABI, ankle brachial index; LVH, left ventricular hypertrophy; eGFR, estimated glomerular filtration rate; R, right; L, left; SD, standard deviation; CVD, cardiovascular disease; PAD, peripheral artery disease; DMR, diabetes mellitus retinopathy; DSN, distal sensory neuropathy.

Table 2 ORs for diabetes complications by serum NT-proBNP values

	NT-proBNP level (pg/mL)			P for trend	Log-NT-proBNP (pg/mL)	P for trend
	1st tertile (<31)	2nd tertile (31–78) OR (CI)	3rd tertile (79∼) OR (CI)
Total diabetes complications (N=217) (a∼e)
1) No adjustment	1.00	1.18 (0.62–2.27)	6.10 (2.52–17.14)	<0.0001	3.51 (2.03–6.43)	<0.0001
2) Adjusted for age, sex, duration	1.00	0.84 (0.40–1.77)	4.14 (1.37–15.59)	0.0081	2.32 (1.21–4.74)	0.0101
3) Full adjustment	1.00	0.96 (0.44–2.09)	5.04 (1.60–19.63)	0.0051	2.60 (1.32–5.53)	0.0084
a) CVD (n=88)
1) No adjustment	1.00	2.51 (1.15–5.64)	15.09 (5.66–46.17)	<0.0001	11.15 (4.77–30.57)	<0.0001
2) Adjusted for age, sex, duration	1.00	1.66 (0.67–4.14)	8.30 (2.48–33.57)	0.0014	5.66 (2.29–16.69)	<0.0001
3) Full adjustment	1.00	1.85 (0.71–4.91)	9.33 (2.70–38.99)	0.0010	6.34 (2.44–20.21)	<0.0001
b) nephropathy (n=97)
1) No adjustment	1.00	0.80 (0.37–1.73)	5.95 (2.31–17.56)	<0.0001	3.08 (1.75–5.82)	<0.0001
2) Adjusted for age, sex, duration	1.00	0.64 (0.26–1.51)	4.90 (1.47–19.83)	0.0015	2.42 (1.23–5.21)	0.0100
3) Full adjustment	1.00	0.73 (0.29–1.84)	6.23 (1.77–26.78)	0.0012	2.71 (1.33–6.11)	0.0052
c) DSN (n=135)
1) No adjustment	1.00	1.48 (0.73–3.01)	6.94 (2.75–20.16)	<0.0001	5.55 (2.77–12.45)	<0.0001
2) Adjusted for age, sex, duration	1.00	1.12 (0.50–2.48)	4.87 (1.54–18.84)	0.0124	3.75 (1.70–9.42)	0.0007
3) Full adjustment	1.00	1.35 (0.58–3.19)	6.60 (1.97–27.16)	0.0048	5.17 (2.13–15.04)	<0.0001
d) DMR (n=74)
1) No adjustment	1.00	2.08 (0.88–5.06)	11.77 (4.18–37.88)	<0.0001	10.49 (4.26–30.81)	<0.0001
2) Adjusted for age, sex, duration	1.00	1.97 (0.72–5.53)	10.40 (2.72–48.47)	0.0017	8.79 (3.05–31.09)	<0.0001
3) Full adjustment	1.00	2.75 (0.94–8.45)	13.78 (3.34–70.75)	0.0008	12.10 (3.62–54.23)	<0.0001
e) PAD (n=28)
1) No adjustment	1.00	1.13 (0.19–6.59)	34.50 (8.78–184.83)	<0.0001	25.72 (7.07–140.34)	<0.0001
2) Adjusted for age, sex, duration	1.00	1.32 (0.19–9.61)	40.86 (5.84–481.87)	<0.0001	13.11 (3.20–82.70)	0.0001
3) Full adjustment	1.00	1.14 (0.10–11.75)	86.79 (9.23–1,632.73)	<0.0001	19.74 (4.03–171.38)	<0.0001

Notes: model 1, no adjustment; model 2, adjusted for age, sex, and log-duration of diabetes; model 3, full adjustment (model 2 plus BMI, HbA_1c).

Abbreviations: OR, odds ratio, CI, confidence interval; NT-proBNP, N-terminal fragment of probrain natriuretic peptide; CVD, cardiovascular disease; DSN, distal sensory neuropathy; DMR, diabetes mellitus retinopathy; PAD, peripheral artery disease; BMI, body mass index; HbA_1c, hemoglobin A_1c.