The Level Of Plasma Brain Natriuretic Peptide On Assessing Cardiovascular Risk In Patients With Type 2 Diabetes

Objective To explore the relationship between plasma level of B-type natriuretic peptide(BNP)and cardiovascular risk in patients with type 2 diabetes,whether these levels were corelated with the criticality of coexistent coronary heart disease(CHD), whether these levels could assess the prognosis of CHD in the near future in patients with type 2 diabetes.Methods 154 patients with type 2 diabetes were selected in this study.These subjects who were 31 to 79 years of age,no history of congenital heart disease,Cardiomyopathy,valvular heart disease,pulmonary heart disease,Atrial Fibrillation,heart failure,renal insufficiency.There were 95 patients combined CHD and 65 patients combined hypertension,Patients who combined CHD were diveded 3 groups: acute myocardial infarction(AMI),32 patients;unstable angina pectoris(UAP),33 patients;and stable angina pectoris(SAP),30 patients.We first investigate whether the plasma brain natriuretic(BNP)levels were affected by the cardiovascular risk in patients with type 2 diabetes;second,we investigated the criticality of coexistent CHD and the prognosis of CHD in the near future in patients with type 2 diabetes. BNP concentration in each sample was measured with a chemiluminescent immunoenzymatic assay(Triage BNP Test,Biosite Incorporated)and echocardiography was perfomed in all patients to detect heart function.All data was analyzed with SPSS 10.0 statistical software:Numerical data was reported as the median value t standard deviation;Significant test uses t or SNK-q test;Correlation test uses Spearman's rank correlation;probability value was considered when P＜0.05.Results 1.The plasma brain natriuretic(BNP)levels were correlated with age,CRP, combined diseases such as Hypertension and CHD in patients with Type 2 diabetes (r=0.631,0.672,0.762,0.857,P＜0.05),BNP levels were not correlated with the duration of diabetes,HbA1c level,hyperlipidemia,BMI in patients with Type 2 diabetes.The plasma BNP level increased in proportion to aging.2.the plasma BNP level in patients with hypertension was significantly elevated in comparison with that of patients without hypertension(314.7±125.3pg/ml vs 136.8±98.7pg/ml,p＜0.001),ACEI or calcium antagonist could not affect the plasma BNP level in diabetic patients with hypertension.3.Plasma level of BNP were 43.04±7.22 pg/ml,170.93±27.89 pg/ml,539.45±103.65 pg/ml and 37.64±21.5 pg/ml in patients combined with SAP,UAP,AMI and patnents without CHD respectively.The level of BNP was significantly higher in AMI than that in other three groups(P＜0.001);the level of BNP was significantly higher in UAP than that in SAP or the group of without CHD(P＜0.001);the level of BNP was higher in SAP than that in the group of without CHD(P＞0.05).BNP level were highly correlated with cardiac troponin T(cTnT)in UAP and AMI(r= 0.948,P＜0.001).4.The prognosis of patients with CHD were correlated with the levels of BNP in the near future,BNP levels≥485 pg/mL may be one of biomarkers to assess the risk of diabetic patients with CHD.ConclusionThe plasma brain natriuretic(BNP)levels were correlated with age,CRP, combined diseases such as Hypertension and CHD in patients with Type 2 diabetes, BNP levels were not correlated with the duration of diabetes,HbA1c level, hyperlipidemia and BMI.Plasma levels of BNP were associated with clinical phenotypes of CHD in diabetic patients,it may be one of biomarkers to assess the risk of diabetic patients with CHD.