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Plasma NT-proBNP and white matter hyperintensities in type 2 diabetic patients

DOI: 10.1186/1475-2840-11-119

Keywords: Type 2 diabetes, Plasma NT-proBNP, 3-D magnetic resonance imaging, White matter hyperintensities, Brain parenchymal fraction

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We measured P-NT-proBNP(ng/l) in 20 diabetic patients without prior stroke but with(n?=?10) or without(n?=?10) asymptomatic coronary artery disease(CAD) in order to include patients with a wide-ranging CV risk profile. All patients and 26 controls had a 3D MRI and brain volumes(ml) with WMH and brain parenchymal fraction(BPF), an indicator of brain atrophy, were determined.P-NT-proBNP was associated with WMH in linear regression analysis adjusted for CV risk factors(r?=?0.94, p?=?0.001) and with BPF in univariate analysis(r?=?0.57, p?=?0.009). Patients divided into groups of increased P-NT-proBNP levels were paralleled with increased WMH volumes(geometric mean[SD];(2.86[5.11] ml and 0.76[2.49] ml compared to patients with low P-NT-proBNP 0.20[2.28] ml, p?=?0.003)) and also when adjusted for age, sex and presence of CAD(p?=?0.017). The association was strengthened by CV risk factors and we did not find a common heart or brain specific driver of both P-NT-proBNP and WMH. Patients and particular patients with CAD had higher WMH, however no longer after adjustment for age and sex.P-NT-proBNP was associated with WMH in type 2 diabetic patients, suggesting a linkage between heart and brain disease.Manifest atherosclerosis that includes strokes is the most important determinant of the excessive morbidity and mortality in patients with type 2 diabetes, especially in patients with microalbuminuria [1]. Although medical treatment aimed at reduction of established conventional risk factors is effective in reducing the increased cardiovascular morbidity and mortality in patients with diabetes, there is still excess morbidity and mortality compared to the background population [2]. Detection of subclinical atherosclerotic manifestations in patients with diabetes in order to be able to identify patients at risk and start appropriate intervention at an early stage therefore seems evident.Elevated plasma N-terminal-proBNP (P-NT-proBNP) levels released from the heart as well as whit


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