Metformin treatment may be associated with decreased levels of NT-proBNP in patients with type 2 diabetes

Adv Med Sci. 2013;58(2):362-8. doi: 10.2478/ams-2013-0009.

Abstract

Purpose: Individuals with type 2 diabetes (T2DM) are at increased risk of cardiovascular disease, including heart failure (HF). In patients with T2DM elevated serum concentrations of the N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) correlate with cardiovascular morbidity and mortality. We aimed to identify predictors of increased serum NT-proBNP levels in patients with T2DM.

Methods: The study included 185 patients with T2DM treated with either oral antidiabetic agents (49.7%) or insulin (17.8%), or both (32.5%). We divided the patients into two groups: with high (>200 pg/mL) and low (≤200 pg/mL) NT-proBNP concentrations.

Results: We found differences between the patients with high and low NT-proBNP levels including age, prevalence of dyslipidemia and HF, history of previous myocardial infarction (MI), heart rate, hemoglobin level, platelet count, creatinine, urea and uric acid concentrations, use of beta-blockers, loop diuretics, metformin and insulin. In a multivariate analysis metformin was a negative predictor of increased NT-proBNP concentration. Age, history of HF and decreased estimated glomerular filtration rate (eGFR) were positive predictors. We found no correlation between NT-proBNP serum concentration and insulin treatment or history of coronary artery disease or MI.

Conclusion: Metformin correlates with lower concentrations of NT-proBNP in patients with T2DM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Atherosclerosis / drug therapy
  • Atherosclerosis / mortality
  • Biguanides / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / mortality*
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / mortality
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / mortality
  • Diuretics / therapeutic use
  • Female
  • Heart Failure / drug therapy
  • Heart Failure / mortality
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use
  • Male
  • Metformin / therapeutic use*
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors

Substances

  • Adrenergic beta-Antagonists
  • Biguanides
  • Diuretics
  • Hypoglycemic Agents
  • Insulin
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Metformin