Year: 2014
Type: article
Abstract: including type 2 diabetes mellitus, hypertension (HTN), and heart disease are worldwide epidemics with incompletely understood associations. Mechanisms underlying the association of HTN and obesity include upregulation of the renin-angiotensin-aldosterone system, sympathetic nervous system, insulin resistance, and adipose tissue activity, but a paradoxically downregulated cardiac natriuretic peptide system, cardiovascular system, and altered renal function (1). Recent studies suggest that natriuretic peptide deficiency may provide a link between obesity-related HTN and insulin resistance (2). Weight loss through bariatric surgery has reduced or eliminated HTN in multiple randomized controlled trials, perhaps through decreased plasma volume, but other mechanisms including changes in the cardiac natriuretic peptide system and lipolysis remain obscure (3). Understanding natriuretic peptide concentration changes following Roux-en-Y gastric bypass (RYGB) surgery may help elucidate the mechanism and impact of paradoxically low concentrations in obesity. We characterized changes in B-type natriuretic peptide (BNP) and N-telopeptide pro-BNP (NT-proBNP) in obese subjects after RYGB surgery by measuring concentrations at baseline and 6, 12, and 24 months postoperatively to enhance our understanding of BNP’s role in weight loss and hemodynamics in this population. We studied 40 obese subjects with BMI $35 kg/m2 and at least one comorbid conditionwho participated in a separate randomized, controlled clinical trial examining the effects of RYGB surgery combined with omentectomy. That study was published previously (4). We obtained previously collected plasma samples from subjects randomized to RYGB alone or RYGB with omentectomy at surgery. This longitudinal study comprised five study visits at which blood was collected in EDTA tubes, centrifuged immediately, and plasma was stored at 2808C until assays were performed. BNP and NT-proBNP were measured using commercially available peptide enzyme immunoassays
Source: Diabetes Care
DOI: 10.2337/dc13-2449
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Eli Lilly and Company, Vanderbilt University, Vanderbilt Institute for Clinical and Translational Research, Georgia Clinical and Translational Science Alliance, National Institutes of Health, Vanderbilt Diabetes Research and Training Center, Vanderbilt University Medical Center, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: G1166885641, G117257630, Renin-Angiotensin & Fibrinolysis Interaction in Humans, Training Program in Cardiovascular Pharmacology, G2304076072, RYGB Improves Metabolism by Interrupting the Gastric Adipose Tissue Axis, G4951618211, Role of the Omentum in the Treatment of Morbid Obesity, The Vanderbilt Institute for Clinical and Translational Research (VICTR) UL1, The Vanderbilt Institute for Clinical and Translational Research (VICTR), Diabetes Research and Training Center, G9000052735, Vanderbilt Diabetes Research Center
OpenAlex ID: W2111722535