A State of Natriuretic Peptide Deficiency
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A State of Natriuretic Peptide Deficiency. / Nyberg, Michael; Terzic, Dijana; Ludvigsen, Trine P.; Mark, Peter D.; Michaelsen, Natasha B.; Abildstrom, Steen Z.; Engelmann, Mads; Richards, A. Mark; Goetze, Jens P.
In: Endocrine Reviews, Vol. 44, No. 3, 2023, p. 379–392.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - A State of Natriuretic Peptide Deficiency
AU - Nyberg, Michael
AU - Terzic, Dijana
AU - Ludvigsen, Trine P.
AU - Mark, Peter D.
AU - Michaelsen, Natasha B.
AU - Abildstrom, Steen Z.
AU - Engelmann, Mads
AU - Richards, A. Mark
AU - Goetze, Jens P.
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - ANP
KW - BNP
KW - CNP
KW - natriuretic peptide
KW - obesity
KW - hypertension
KW - TYPE-1 DIABETES-MELLITUS
KW - C-TYPE
KW - HEART-FAILURE
KW - PLASMA-CONCENTRATIONS
KW - BLOOD-PRESSURE
KW - CIRCULATING LEVELS
KW - GENE VARIANT
KW - BODY-MASS
KW - PRO-BNP
KW - ATRIAL
U2 - 10.1210/endrev/bnac029
DO - 10.1210/endrev/bnac029
M3 - Review
C2 - 36346821
VL - 44
SP - 379
EP - 392
JO - Endocrine Reviews
JF - Endocrine Reviews
SN - 0163-769X
IS - 3
ER -
ID: 330777617