Differential response of the natriuretic peptide system to weight loss and exercise in overweight or obese patients. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Haufe, Sven; Kaminski, Jana; Utz, Wolfgang; Haas, Verena; Mähler, Anja; Daniels, Martin A.; Birkenfeld, Andreas L.; Lichtinghagen, Ralf; Luft, Friedrich C.; Schulz-Menger, Jeanette; Engeli, Stefan; Jordan, Jens
• Is Part Of: Journal of hypertension. Volume 33:Issue 7(2015:Jul.)
• Publication Date: 2015-07
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000573
• Languages: English
• ISSNs: 1473-5598

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>Relative atrial natriuretic peptide (ANP) deficiency has been implicated in the pathogenesis of obesity-associated cardiovascular and metabolic disease. We tested the hypothesis that more than 5% body weight reduction through 6 months hypocaloric dieting alters ANP release at rest and more so during exercise in overweight or obese patients.</p> </sec> <sec> <title>Methods:</title> <p>Venous mid-regional pro-ANP concentration was assessed at rest and after incremental exhaustive exercise testing before and after weight reduction. We also measured natriuretic peptide receptor A and C mRNA expression in subcutaneous adipose tissue to gauge both ANP responsiveness and clearance mechanisms.</p> </sec> <sec> <title>Results:</title> <p>The average weight reduction of 9.1 ± 3.8 kg was associated with reductions in visceral and subcutaneous abdominal fat mass, liver fat content, insulin resistance, and ambulatory blood pressure. However, mid-regional pro-ANP plasma concentrations were unchanged with weight loss (51 ± 24 vs. 53 ± 24 pmol/l). Exercise elicited similar acute mid-regional pro-ANP increases before and after weight loss. Adipose tissue natriuretic peptide receptor type A mRNA expression remained unchanged, whereas natriuretic peptide receptor type C mRNA decreased with weight loss.</p> </sec> <sec> <title>Conclusions:</title> <p>We conclude that physical exercise acutely increases ANP release in obese patients, whereas modest diet-induced weight loss primarily affects ANP clearance mechanisms. Interventions combining weight loss and regular physical exercise may be particularly efficacious in reversing obesity-associated relative natriuretic peptide deficiency.</p> </sec> </abstract>