Abstract P089: N-terminal Pro-B-type Natriuretic Peptide And Incident Metabolic Syndrome And Its Components In REGARDS

Introduction: Natriuretic peptides are released in response to cardiomyocyte stretch and are markers of atriopathy and heart failure. Lower N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been associated with greater risk for diabetes mellitus (DM) in prospective studies, but associations of B-type natriuretic peptides with incident metabolic syndrome (MetS) have not been evaluated. Hypothesis: Higher baseline NT-proBNP is associated with lower risk for incident metabolic syndrome and its components. Methods: We included 2,144 Black and white participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study without MetS at baseline (2003-2007). These participants had baseline plasma NT-proBNP measured by immunoassay and underwent follow-up in 2013-2016. Those with NT-proBNP >100 pg/mL were excluded. Incident MetS was defined as ≥3 harmonized criteria at follow-up: high systolic blood pressure, increased waist circumference, dysglycemia, high triglycerides, and low high-density lipoprotein. Three sequential logistic regression models estimated odds ratios of incident MetS and for individual MetS criteria, incorporating demographic factors, metabolic risk factors, and laboratory markers related to insulin resistance. Results & Conclusions: Over mean 9.4 (SD 1.0) years follow up, 426 participants (mean [SD] age 60.7 [0.4] years, 193 (45%) Black race, 228 (54%) women) developed MetS. Median [IQR] plasma NT-proBNP was 34 [16-58] pg/mL. No significant association of NT-proBNP with incident MetS was observed (Table). There were no observed interactions of this association by race (P=0.22), age (P=0.15), or sex (P=0.60). Each 1-SD higher log NT-proBNP was associated with lower risk of incident dysglycemia, but not other MetS components. The metabolic implications of B-type natriuretic peptides may be limited to glycemic homeostasis.