B-Type Natriuretic Peptide Is Associated With Sarcopenia in Older Patients Without Symptomatic Heart Failure

B-type natriuretic peptide (BNP) has been identified as a biomarker of sarcopenia in community-dwelling populations and in patients with heart failure. However, it remains unclear whether BNP is associated with sarcopenia in the pre-heart failure stage in older adults with cardiometabolic diseases.

In this cross-sectional study, BNP was measured in 697 older outpatients with cardiometabolic disease and no history of heart failure or atrial fibrillation. Sarcopenia was assessed using the Asian Working Group for Sarcopenia criteria 2019. The participants were grouped according to whether their BNP level was < 35 pg/mL, 35 ≤ BNP < 100 pg/mL, or ≥ 100 pg/mL in accordance with the Japanese guideline on diagnosis and treatment of heart failure.

The mean age was 78.8 ± 6.8 years. Sarcopenia was present in 38% of patients. Natural log-transformed BNP was significantly related to gait speed (B = -0.278, SE = 0.128, p = 0.031) and hand grip strength (B = -0.016, SE = 0.007, p = 0.013) even after adjusting for age, sex, body mass index, estimated glomerular filtration rate, regular alcohol intake, smoking status, diabetes mellitus, dyslipidemia, hypertension, stroke, and antihypertensive medication use. Multivariate logistic regression analysis revealed that those with BNP ≥ 100 pg/mL had an increased risk of sarcopenia (OR 2.33, 95% CI 1.18-4.60), low appendicular skeletal mass index (OR 2.47, 95% CI 1.19-5.15), and low handgrip strength (OR 2.44, 95% CI 1.27-4.68).

Increased BNP (≥ 100 pg/mL) was associated with sarcopenia even in individuals with cardiometabolic disease and no history of atrial fibrillation or symptomatic heart failure.