Should malnutrition risk be assessed in older patients with elevated levels of NT-proBNP?

Introduction An inverse relationship between natriuretic peptides (N‑terminal fragment of the prohormone brain natriuretic peptide [NT‑proBNP]) and body mass index (BMI) among healthy people and patients with chronic heart failure (CHF) was observed. Objectives The aim of the study was to assess the relationship between nutritional status and NT‑proBNP concentrations in older persons. Patients and methods NT‑proBNP concentrations, medical histories, and malnutrition risk using Mini Nutritional Assessment were evaluated. Body composition was measured with dual energy X‑ray absorptiometry. The relationship of nutritional status with NT‑proBNP concentrations (in tertiles) was assessed. Results The mean (SD) age of 106 participants was 72.16 (9.38) years. Heart failure was diagnosed in 72.6% of patients. The risk of malnutrition was recognized in 28.3%, and the percentage of patients at risk increased in subsequent NT‑proBNP tertiles: from 16.7% in the first tertile to 48.6% in the third tertile (P = 0.005). The risk of malnutrition was associated with an increase in NT‑proBNP concentrations per tertile (odds ratio [OR], 2.30; 95% CI, 1.30-4.07; P = 0.004). Based on a multivariable logistic model, the NT‑proBNP concentration in the third tertile was associated with an over 9‑fold higher risk of malnutrition (OR, 9.80; 95% CI, 2.00-48.17; P = 0.005) as compared with the lowest concentration. Among patients with CHF, the relationship between NT‑proBNP and nutritional status was even stronger. Conclusions High NT‑proBNP levels contribute to increased risk of malnutrition in older patients with heart failure. In patients with elevated NT‑proBNP levels, the risk of malnutrition should be assessed.