尿,体质指数和心力衰竭的临床结果
John W Ostrominski1, Brendon L Neuen2, Brian L Claggett3
1: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; : Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Journal of the American College of Cardiology
|September 2, 2025
概括
在心力衰竭患者中,较高的体重指数 (BMI) 与较低的N-终端亲B型尿素 (NT-proBNP) 水平有关. 目前的NT-proBNP值可能低估了高BMI个体的风险.
科学领域:
- 心脏病学
- 生物标志物研究
- 肥胖药物
背景情况:
- 尿酸是心力衰竭 (HF) 的关键生物标志物,用于风险分层和临床试验资格.
- 目前的HF指南和试验标准往往不包括脂肪度,如体重指数 (BMI).
研究的目的:
- 调查N-终端亲B型尿素 (NT-proBNP) 与轻微减少或保留射出分数的HF (HFmrEF/HFpEF) 的临床结果之间的关系.
- 根据身体质量指数 (BMI) 的类别来分层这个协会.
主要方法:
- 这是一项对4项全球随机对照HF试验的综合分析.
- 评估NT-proBNP与心血管死亡或HF住院,心血管死亡,HF住院和全因死亡的相关性.
- 用BMI作为连续和分类变量的分层分析.
主要成果:
- 在14750名参与者中,较高的基线BMI与较低的NT- proBNP水平非线性相关.
- 增加的NT-proBNP独立预测了不良心血管结果,但在较高的BMI群体中,这种关联变得模糊.
- 对于类似的绝对风险,NT-proBNP水平在BMI≥35kg/ m2的个体中明显低于BMI<35kg/ m2的个体.
结论:
- 标准NT-proBNP值可能低估了HF不良结果的绝对风险.
- 固定的NT-proBNP截止值可能不是所有BMI范围内的最佳风险分层.
- 在高BMI人群中,可能需要较低的NT-proBNP值来准确评估风险.
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