Abstract
Abstract only
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is used to identify cardiac stress, manage, and treat cardiac disease progression, and diagnose heart failure (HF). Notably, this peptide is paradoxically lower in HF patients who are obese. In this regard, a growing body of evidence has investigated its association with body composition, but the relationship between NT-proBNP and muscle quality is unknown. Therefore, we investigated the associations between abdominal muscle volume and density with NT-proBNP. We conducted a cross-sectional analysis of participants from the MESA Abdominal Body Composition, Inflammation, and Cardiovascular Disease (ABC) ancillary study. At exams 2 and 3, participants underwent abdominal computed tomography (CT) scans and had venous blood drawn. Images were analyzed using software (MIPAV 41.2), and Hounsfield units (HU) were used to determine the density of muscle groups of interest (total abdominal muscle [oblique, rectus abdominus, paraspinus muscles, psoas], stabilization muscles [oblique, rectus abdominus, paraspinus muscle] and, psoas muscle). NT-proBNP was log-transformed due to the skewed distribution of the variable. Fat, lean, and total tissue areas were measured in square centimeters. Multivariable linear regression models were used to test the associations between muscle quantity and quality (area and density), separately, with adjustment for age, sex, race/ethnicity, diabetes, smoking, hypertension, moderate-to-vigorous (MVPA), sedentary behavior, height, subcutaneous fat, visceral fat, visceral fat density, leptin, adiponectin, CRP, IL-6, and TNF-alpha. We included 1,489 participants with a mean age 64.8 (9.6) years, and 51.6% were female. The majority were non-Hispanic White (42%), followed by Hispanics (26%), African Americans (18%), and Chinese Americans (14%). After full adjustment, stabilization muscle density was inversely associated with NT-proBNP (β = -0.024, 95% CI: -0.038, -0.010). The results were similar for total abdominal muscle density (β = -0.026, 95% CI: -0.042, -0.010) and psoas muscle density (β = -0.013, 95% CI: -0.026, -0.001). For the latter, addition of muscle area as a covariate attenuated the association β = -0.011, 95% CI: -0.025, 0.002). After minimal adjustment, multivariable models of total abdominal muscle and psoas muscle areas for NT-proBNP were inversely associated but became non-significant with the addition of inflammation biomarkers (leptin, adiponectin, CRP, IL- 6, and TNF-alpha) and muscle density. Area of stabilization muscles and NT-proBNP were not significantly associated. Abdominal muscle
area
and NT-proBNP were not consistently associated, whereas abdominal muscle
density
and NT-proBNP were robustly inversely associated independently of muscle area, sociodemographic characteristics, cardiovascular risk factors, and inflammation biomarkers.