Reduced brain natriuretic peptide levels in class III Obesity: The role of metabolic and cardiovascular factors

A. M.R. Beleigoli, Maria De Diniz, Maria Carmo Nunes, Márcia Melo Barbosa, Stephanie S. Fernandes, Mery Natali Abreu, Antonio L. Ribeiro

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Objective: Brain natriuretic peptide (BNP) has potent lipolytic action and, probably, a role in the biological mechanisms of obesity. Clinically, high levels are found in subjects with heart failure (HF). Low levels and inverse relation to BMI lead to questioning of its clinical utility in obese subjects, but heterogeneous results are found in severe obesity. Methods: In order to describe BNP behavior and its metabolic and cardiovascular determinants in class III obesity, we performed BNP measurement as well as clinical and echocardiographic evaluation of 89 subjects from two public hospitals in Brazil. Multivariate logistic ordinal regression with BNP tertiles as the dependent variable was performed. Results: Mean (± SD) age and BMI (± SD) was 44 ± 11.5 years and 53.2 ± 7.9 kg/m 2, respectively. 72 (81%) participants were women, and 18 (20%) had HF. Median BNP was 9.5 pg/ml(Q1 4.9; Q3 21.2 pg/ml). 30% of BNP values were below the detection limit of the method. In multivariate analysis, left atrial volume (LAV) was the only determinant of BNP levels (p 0.002) with odds-ratio of 1.1 (95% CI 1.03-1.16). Conclusion: BNP levels are low in severe obesity, even in subjects with HF. LAV, which marks diastolic dysfunction, determines BNP levels, but not BMI and metabolic abnormalities.

Original languageEnglish
Pages (from-to)427-432
Number of pages6
JournalObesity Facts
Issue number6
Publication statusPublished - Dec 2011
Externally publishedYes


  • Class III obesity
  • Brain natriuretic peptide
  • Metabolic syndrome
  • Heart failure


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