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Differences in Natriuretic Peptide Levels by Race/Ethnicity (From the Multi-Ethnic Study of Atherosclerosis).

Abstract
Natriuretic peptides (NP) are cardiac-derived hormones with favorable cardiometabolic actions. Low NP levels are associated with increased risks of hypertension and diabetes mellitus, conditions with variable prevalence by race and ethnicity. Heritable factors underlie a significant proportion of the interindividual variation in NP concentrations, but the specific influences of race and ancestry are unknown. In 5597 individuals (40% white, 24% black, 23% Hispanic, and 13% Chinese) without prevalent cardiovascular disease at baseline in the Multi-Ethnic Study of Atherosclerosis, multivariable linear regression and restricted cubic splines were used to estimate differences in serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels according to, ethnicity, and ancestry. Ancestry was determined using genetic ancestry informative markers. NT-proBNP concentrations differed significantly by race and ethnicity (black, median 43 pg/ml [interquartile range 17 to 94], Chinese 43 [17 to 90], Hispanic 53 [23 to 107], white 68 [34 to 136]; p = 0.0001). In multivariable models, NT-proBNP was 44% lower (95% confidence interval -48 to -40) in black and 46% lower (-50 to -41) in Chinese, compared with white individuals. Hispanic individuals had intermediate concentrations. Self-identified blacks and Hispanics were the most genetically admixed. Among self-identified black individuals, a 20% increase in genetic European ancestry was associated with 12% higher (1% to 23%) NT-proBNP. Among Hispanic individuals, genetic European and African ancestry were positively and negatively associated with NT-proBNP levels, respectively. In conclusion, NT-proBNP levels differ according to race and ethnicity, with the lowest concentrations in black and Chinese individuals. Racial and ethnic differences in NT-proBNP may have a genetic basis, with European and African ancestry associated with higher and lower NT-proBNP concentrations, respectively.
AuthorsDeepak K Gupta, Lori B Daniels, Susan Cheng, Christopher R deFilippi, Michael H Criqui, Alan S Maisel, Joao A Lima, Hossein Bahrami, Philip Greenland, Mary Cushman, Russell Tracy, David Siscovick, Alain G Bertoni, Valentina Cannone, John C Burnett, John Jeffrey Carr, Thomas J Wang
JournalThe American journal of cardiology (Am J Cardiol) Vol. 120 Issue 6 Pg. 1008-1015 (Sep 15 2017) ISSN: 1879-1913 [Electronic] United States
PMID28750825 (Publication Type: Journal Article, Multicenter Study, Observational Study)
CopyrightCopyright © 2017 Elsevier Inc. All rights reserved.
Chemical References
  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
Topics
  • Aged
  • Aged, 80 and over
  • Atherosclerosis (blood, ethnology)
  • Biomarkers (blood)
  • Ethnicity
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Morbidity (trends)
  • Natriuretic Peptide, Brain (blood)
  • Peptide Fragments (blood)
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Racial Groups
  • Risk Factors
  • United States (epidemiology)

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