@article{85712f0d1e3548ad8f0c050009d78cc6,
title = "Circulating natriuretic peptide concentrations reflect changes in insulin sensitivity over time in the Diabetes Prevention Program",
abstract = "Aims/hypothesis: We aimed to study the relationship between measures of adiposity, insulin sensitivity and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the Diabetes Prevention Program (DPP). Methods: The DPP is a completed clinical trial. Using stored samples from this resource, we measured BMI, waist circumference (WC), an insulin sensitivity index (ISI; [1/HOMA-IR]) and NT-proBNP at baseline and at 2 years of follow-up in participants randomised to placebo (n=692), intensive lifestyle intervention (n=832) or metformin (n=887). Results: At baseline, log NT-proBNP did not differ between treatment arms and was correlated with baseline log ISI (p<0.0001) and WC (p=0.0003) but not with BMI (p=0.39). After 2 years of treatment, BMI decreased in the lifestyle and metformin groups (both p<0.0001); WC decreased in all three groups (p<0.05 for all); and log ISI increased in the lifestyle and metformin groups (both p<0.001). The change in log NT-proBNP did not differ in the lifestyle or metformin group vs the placebo group (p>0.05 for both). In regression models, the change in log NT-proBNP was positively associated with the change in log ISI (p<0.005) in all three study groups after adjusting for changes in BMI and WC, but was not associated with the change in BMI or WC after adjusting for changes in log ISI. Conclusion/interpretation: Circulating NT-proBNP was associated with a measure of insulin sensitivity before and during preventive interventions for type 2 diabetes in the DPP. This relationship persisted after adjustment for measures of adiposity and was consistent regardless of whether a participant was treated with placebo, intensive lifestyle intervention or metformin.",
keywords = "Diabetes prevention, Insulin sensitivity, NT-proBNP, Natriuretic peptides, Obesity",
author = "Walford, {Geoffrey A.} and Yong Ma and Christophi, {Costas A.} and Goldberg, {Ronald B.} and Petr Jarolim and Edward Horton and Mather, {Kieren J.} and Elizabeth Barrett-Connor and Jaclyn Davis and Florez, {Jose C.} and Wang, {Thomas J.}",
note = "Funding Information: Funding GAW received support from NIH training grant DK007028, from the Scholars in Clinical Science Program of Harvard Catalyst—The Harvard Clinical and Translational Science Center (award no. UL1 RR 025758 and financial contributions from Harvard University and its Funding Information: Acknowledgements The investigators gratefully acknowledge the commitment and dedication of the participants of the DPP. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) provided funding to the clinical centres and the coordinating centre for the design and conduct of the study, and for the collection, management, analysis and interpretation of the data. The Southwestern American Indian centres were supported directly by the NIDDK and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources supported data collection at many of the clinical centres. Funding for data collection and participant support was also provided by the Office of Research on Minority Health, the National Institute of Child Health and Human Development, the National Institute on Aging, the Centers for Disease Control and Prevention, the Office of Research on Women{\textquoteright}s Health, and the American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided medication. This research was also supported, in part, by the Intramural Research Program of the NIDDK. LifeScan, Health O Meter, Hoechst Marion Roussel, Merck-Medco Managed Care, Merck, Nike Sports Marketing, Slim Fast Foods and Quaker Oats donated materials, equipment or medicines for concomitant conditions. McKesson BioServices, Matthews Media Group and the Henry M. Jackson Foundation provided support services under subcontract with the coordinating centre.",
year = "2014",
month = may,
doi = "10.1007/s00125-014-3183-2",
language = "English (US)",
volume = "57",
pages = "935--939",
journal = "Diabetologia",
issn = "0012-186X",
publisher = "Springer Verlag",
number = "5",
}