Fatty Liver is Associated with Low N-terminal pro-B-type Natriuretic Peptide in a Healthy Population: From the Kangbuk Samsung Health Study

Abstract BackgroundFatty liver (FL), insulin resistance (IR), and obesity often coexist, but data on the independent impacts of these factors on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in healthy populations are scarce. We therefore examined the impact of FL, IR and obesity on NT-proBNP levels using a large set of cross-sectional data.MethodsThe associations of FL, IR and obesity with NT-proBNP were analyzed in 39,923 healthy adult participants using Kangbuk Samsung Health Study data. IR was estimated using homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. A multivariable regression model that adjusted for factors that influence NT-proBNP was conducted to identify associations between NT-proBNP and FL on abdominal ultrasound. ResultsA total of 11,704 (29.3%) individuals had FL on abdominal ultrasound. FL, IR and obesity showed independent inverse associations with NT-proBNP after multiple adjustments for baseline characteristics. In a multivariable regression model adjusting for IR and obesity, FL was independently associated with lower levels of NT-proBNP (odds ratio 0.864, 0.849 - 0.880). The combination of FL and IR was a powerful dual predictor, lowering NT-proBNP levels approximately 25% in the generally healthy study population.ConclusionIn this large sample of healthy individuals, FL was independently associated with lower NT-proBNP levels. FL and a high HOMA-IR index are a powerful predictor combination for lower NT-proBNP levels. Further research is needed to elucidate the mechanism underlying the association between FL and NT-proBNP.