Natriuretic peptide levels and predicting risk of developing new diabetes mellitus and metabolic syndrome.

Singh, Jasraj; Adel, Fadi W.; Scott, Christopher G.; Chen, Horng H.

Aims: Define the relationship between N‐terminal atrial natriuretic peptide (NT‐ANP) levels and incident metabolic syndrome and type 2 diabetes mellitus ('metabolic disease') in healthy adults and develop a risk prediction score. Materials and Methods: Retrospective cohort study of Olmsted County Heart Function Study participants, a random sampling of county residents aged 45 years and older (n = 2042). Clinical data were collected during enrolment between 1997 and 2000 and upon follow‐up 4 years later. Outcomes were followed for 8 years. We studied 715 subjects without metabolic disease at enrolment who completed follow‐up, assessing incident metabolic disease as the primary outcome. Youden's index was used to identify optimal cut‐points and develop the risk score. Results: Upon multivariate analysis adjusting for age gender, HDL and triglycerides, higher baseline serum NT‐ANP levels were associated with a lower risk of metabolic disease (OR: 0.65, CI 0.49–0.85, p = 0.002). Higher baseline serum insulin and aldosterone levels were associated with higher risk of incident metabolic disease (OR: 2.04, CI 1.57–2.65, p < 0.001; OR: 1.43, CI 1.14–1.81, p = 0.002, respectively). Baseline serum NT‐ANP < 3337 pg/mL was 96.6% sensitive for future development of metabolic disease. A weighted score including all three biomarkers was 78.6% sensitive and 77.3% specific. Conclusions: In healthy adults aged 45 years or older, higher baseline NT‐ANP levels are associated with a lower four‐year risk of developing metabolic disease. Serum NT‐ANP levels are a sensitive biomarker of future risk of metabolic disease and have screening utility when combined with insulin and aldosterone levels into a composite score.

ATRIAL natriuretic peptides; TYPE 2 diabetes; DISEASE risk factors; METABOLIC disorders; METABOLIC syndrome

Diabetes, Obesity & Metabolism, 2025, Vol 27, Issue 2, p777

1462-8902

Academic Journal

10.1111/dom.16073