In contrast to the cardiac hormones, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP), variations in plasma concentrations of C-type natriuretic peptide (CNP) in healthy adults are ill-defined, limiting their clinical application.
Our objective was to define the effect of age, phenotype (gender, height, BMI), and cardiac and renal function on plasma CNPs in an adults population without renal or cardiovascular disease.
This was a prospective cross-sectional observational study of adult volunteers, aged 21–80 years, randomly selected from the electoral roll.
Plasma CNP and its associated aminoterminal propeptide (NTproCNP) were measured in 258 subjects and related to age, gender, height and plasma creatinine. Subgroup analyses seeking associations with cardiac function (plasma BNP and NTproBNP) and bone turnover bone-specific alkaline phosphatase (bALP) were also determined.
Plasma concentrations of CNPs in men continued to decline from adolescent values to reach a nadir in the 5th decade after which values increased. Similar but less marked changes occurred in women. In both sexes, NTproCNP was inversely and independently correlated with height. In contrast to B-type natriuretic peptides (BNPs), NTproCNP was higher in men, significantly related to creatinine and positively related to bALP.
Gender- and age-specific changes affect CNPs in adults. Inverse associations of NTproCNP with adult height, positive correlation with creatinine – and in contrast to CNP – no association with BNP are further unique findings distinguishing NTproCNP, which need to be considered in future studies.
[Show abstract][Hide abstract] ABSTRACT: Background:
C-type natriuretic peptide (CNP) is a paracrine growth factor critical in endochondral bone growth. Amino-terminal CNP (NTproCNP), measurable in plasma, correlates with growth-plate activity and can be used as a biomarker of growth velocity in children. Because severe inflammation in adults increases CNP, we studied CNP peptides and inflammatory markers in children with acute illness.
Forty-two children aged 2 mo to 5 y with acute illness warranting admission to an acute assessment unit were studied. Fifteen age-matched healthy children attending an outpatient clinic served as controls. Venous CNP concentrations were measured at admission, along with markers of acute inflammation (body temperature, C-reactive protein (CRP), and white blood cell count) in children with acute illness.
NTproCNP and CNP SD scores (SDSs) in the acutely ill group were significantly suppressed (P < 0.001) as compared with those of healthy children or healthy population norms. NTproCNP SDS was significantly inversely related to body temperature (r = -0.42, P < 0.01) and CRP (r = -0.56, P < 0.001).
Acute inflammation in young children potently reduces CNP production, which needs to be considered when screening for growth disorders. Our data raise the possibility that the adverse effects of inflammatory cytokines on skeletal growth may be mediated in part by reduced CNP.
Pediatric Research 06/2013; 74(2). DOI:10.1038/pr.2013.92 · 2.31 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Atrial natriuretic peptide (ANP) is a potent lipolytic agent that acts in adipose tissue. Low levels of ANP might lead to reduced lipolysis and excessive weight gain, which could be one of the biological alterations that contribute to the development of obesity. The aim of the present study was to evaluate the relationship between metabolic syndrome and fasting serum ANP concentrations in older adults.
Fasting blood samples were obtained from 90 older adults. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.
A total of 40 older adults (44.4%) had metabolic syndrome. Fasting ANP level was negatively correlated with metabolic syndrome (P = 0.015). Univariate linear regression analysis showed that high-density lipoprotein cholesterol (P < 0.001) was positively correlated with serum logANP levels, whereas waist circumference (P = 0.001) and body fat mass (P = 0.002) were negatively correlated with fasting serum logANP levels. Multivariate forward stepwise linear regression analysis of the significant variables showed that high-density lipoprotein cholesterol (β = 0.419, R(2) = 0.268, P < 0.001) and body fat mass (β = -0.396, R(2) = 0.154, P = 0.002) were independent predictors of fasting serum logANP levels in geriatric persons.
Serum ANP levels were reduced in geriatric persons affected by metabolic syndrome. Body fat mass and high-density lipoprotein cholesterol were independent predictors of fasting serum ANP levels in older adults. Geriatr Gerontol Int 2013; ●●: ●●-●●.
[Show abstract][Hide abstract] ABSTRACT: Context. C-type Natriuretic Peptide (CNP), a vasoactive product of the endothelium, is markedly increased during placentation in ovine pregnancy, and is further stimulated by nutrient restriction. Whether CNP products change in human pregnancy is unknown. Objectives. To compare serial changes in maternal plasma CNP peptides during normal pregnancy with changes in pregnancy complicated by adverse events, and relate these to fetal growth and placental CNP content. Design. This was a prospective observational study undertaken in a tertiary care centre. Methods. We studied changes in maternal plasma aminoterminal proCNP (NTproCNP) and CNP at monthly intervals, fetal growth, placental and umbilical plasma CNP peptides in 51 women, 28 of whom experienced an adverse event and 23 were uneventful. Age matched healthy non-pregnant women served as a reference range for NTproCNP. Results. Compared to non-pregnant women, maternal plasma NTproCNP in uneventful pregnancy was significantly reduced from first sampling (16 weeks gestation) until 36 weeks. In contrast, in complicated pregnancy levels did not decline and were significantly higher (p<0.001 by ANOVA) than in normal pregnancy from 20 weeks. Highest values occurred in women later developing hypertension and fetal growth disorders. Placental concentration of NTproCNP was unrelated to maternal NTproCNP but strongly correlated with cord plasma levels. Conclusions. Maternal NTproCNP is significantly raised in women who later exhibit a range of obstetric adverse events. Lack of association with placental concentrations suggests that these changes represent an adaptive response within the maternal circulation to a threatened nutrient supply to the fetus.
The Journal of Clinical Endocrinology and Metabolism 01/2014; 99(4):jc20133758. DOI:10.1210/jc.2013-3758 · 6.21 Impact Factor
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