Atrial Natriuretic Peptide in the high normal range is associated with lower prevalence of insulin resistance
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Context We have previously shown that high levels of atrial natriuretic peptides (ANP) are associated with decreased risk of future diabetes development; however, the mechanism behind this relationship is not fully understood.
OBJECTIVE: In this study, we prospectively analyzed whether baseline plasma levels of mid-regional proANP (MR-proANP) are associated with insulin resistance and post challenge incretin secretion after long-term follow-up. Design/Setting/Patients MR-proANP was measured in 2243 non-diabetic individuals at baseline examination of Malmö Diet and Cancer Cardiovascular cohort. At re-examination 16.5 years later, glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1), insulin, glucose and glucagon were measured during an oral glucose tolerance test.
RESULTS: Linear regression analyses showed that each 1 SD increment of baseline MR-proANP levels was inversely associated with insulin resistance calculated as HOMA-IR (per 1 SD change β= -0.066, p-value 0.001) at follow-up. Logistic regression analysis showed that each 1 SD increment of baseline ANP levels resulted in lower risk of belonging to upper quartile of HOMA-IR at follow-up (OR 0.88; CI 95 % 0.78-0.99; p-value 0.043). In linear regression analyses each 1 SD increment in baseline MR-proANP levels was associated with greater GIP release (per 1 SD change: β= 0.055; p-value= 0.020) 120 minutes after 75g glucose intake, but not with GLP-1 release (per 1 SD change: β= 0.016; p-value= 0.493) 120 minutes after 75g glucose intake at 16.5 years of follow up.
CONCLUSION: Midlife exposure to ANP within the high normal range is associated with lower risk of insulin resistance. Further, midlife exposure to ANP within the high normal range is associated with greater post challenge GIP secretion at follow-up, possibly explaining the lower prevalence of insulin resistance.
|Tidsskrift||The Journal of clinical endocrinology and metabolism|
|Status||Udgivet - 27 jan. 2016|