A State of Natriuretic Peptide Deficiency

Michael Nyberg, Dijana Terzic, Trine P. Ludvigsen, Peter D. Mark, Natasha B. Michaelsen, Steen Z. Abildstrom, Mads Engelmann, A. Mark Richards, Jens P. Goetze*

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

9 Citations (Scopus)
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Abstract

Measurement of natriuretic peptides (NPs) has proven its clinical value as biomarker, especially in the context of heart failure (HF). In contrast, a state of partial NP deficiency appears integral to several conditions in which lower NP concentrations in plasma presage overt cardiometabolic disease. Here, obesity and type 2 diabetes have attracted considerable attention. Other factors-including age, sex, race, genetics, and diurnal regulation-affect the NP "armory" and may leave some individuals more prone to development of cardiovascular disease. The molecular maturation of NPs has also proven complex, with highly variable O-glycosylation within the biosynthetic precursors. The relevance of this regulatory step in post-translational propeptide maturation has recently become recognized in biomarker measurement/interpretation and cardiovascular pathophysiology. An important proportion of people appear to have reduced effective net NP bioactivity in terms of receptor activation and physiological effects. The state of NP deficiency both entails a potential for further biomarker development and could also offer novel pharmacological possibilities. Alleviating the state of NP deficiency before development of overt cardiometabolic disease in selected patients could be a future path for improving precision medicine.

Original languageEnglish
JournalEndocrine Reviews
Volume44
Issue number3
Pages (from-to)379–392
ISSN0163-769X
DOIs
Publication statusPublished - 2023

Keywords

  • ANP
  • BNP
  • CNP
  • natriuretic peptide
  • obesity
  • hypertension
  • TYPE-1 DIABETES-MELLITUS
  • C-TYPE
  • HEART-FAILURE
  • PLASMA-CONCENTRATIONS
  • BLOOD-PRESSURE
  • CIRCULATING LEVELS
  • GENE VARIANT
  • BODY-MASS
  • PRO-BNP
  • ATRIAL

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