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Abstract
Obesity is associated with a “natriuretic handicap” indicated by reduced N-terminal fragment of proBNP (NT-proBNP) concentration. While gastric bypass surgery improves the natriuretic handicap, it is presently unclear if sleeve gastrectomy exhibits similar effects. We examined NT-proBNP serum concentration in n = 72 obese participants without heart failure before and 6 months after sleeve gastrectomy (n = 28), gastric bypass surgery (n = 19), and 3-month 800 kcal/day very-low calorie diet (n = 25). A significant weight loss was observed in all intervention groups. Within 6 months, NT-proBNP concentration tended to increase by a median of 44.3 pg/mL in the sleeve gastrectomy group (p = 0.07), while it remained unchanged in the other groups (all p ≥ 0.50). To gain insights into potential effectors, we additionally analyzed NT-proBNP serum concentration in n = 387 individuals with different metabolic phenotypes. Here, higher NT-proBNP levels were associated with lower nutritional fat and protein but not with carbohydrate intake. Of interest, NT-proBNP serum concentrations were inversely correlated with fasting glucose concentration in euglycemic individuals but not in individuals with prediabetes or type 2 diabetes. In conclusion, sleeve gastrectomy tended to increase NT-proBNP levels in obese individuals and might improve the obesity-associated “natriuretic handicap”. Thereby, nutritional fat and protein intake and the individual glucose homeostasis might be metabolic determinants of NT-proBNP serum concentration.
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1 University of Kiel, Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, Kiel, Germany (GRID:grid.9764.c) (ISNI:0000 0001 2153 9986)
2 Helios Klinik Lengerich, Lengerich, Germany (GRID:grid.9764.c)
3 University of Kiel, Institute for Clinical Molecular Biology, Kiel, Germany (GRID:grid.9764.c) (ISNI:0000 0001 2153 9986)
4 University of Kiel, Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Internal Medicine 1, Kiel, Germany (GRID:grid.9764.c) (ISNI:0000 0001 2153 9986); University of Kiel, Institute for Clinical Molecular Biology, Kiel, Germany (GRID:grid.9764.c) (ISNI:0000 0001 2153 9986)
5 University of Kiel, Department of General and Abdominal Surgery, Kiel, Germany (GRID:grid.9764.c) (ISNI:0000 0001 2153 9986)