DOI: 10.14260/jemds/2015/1252 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 4/ Issue 50/ June 22, 2015 Page 8654 NT-pro-BNP IN DIABETES MELLITUS Kamakhya Kumar 1 , Arunima Datta 2 , Pramod Kumar 3 , Anant Kumar 4 , Arup Bandyopadhyay 5 HOW TO CITE THIS ARTICLE: Kamakhya Kumar, Arunima Datta, Pramod Kumar, Anant Kumar, Arup Bandyopadhyay. “NT-pro-BNP in Diabetes Mellitus”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 50, June 22; Page: 8654-8660, DOI: 10.14260/jemds/2015/1252 ABSTRACT: BACKGROUND: Brain natriuretic peptide (BNP) is a peptide hormone that is synthesized largely by the heart in the form of pre-pro-BNP which is cleaved to pro-BNP, and then proteolyzed to BNP and NT-pro-BNP. ANP, BNP and NT-pro-BNP are sensitive diagnostic markers for heart failure. NT-pro-BNP being more sensitive is preferable to BNP and ANP for the detection of heart failure. Several studies have shown that NT-pro-BNP level is higher in diabetics. We have here tried to study the same dividing the diabetic population duration-wise. MATERIALS AND METHODS: Patients with uncomplicated diabetes mellitus aged below 50 years were selected irrespective of sex. Patients without diabetes mellitus were taken as controls (Group A). Others viz., Group B consists of DM patients suffering from diabetes mellitus for a period <1 year, Group C consists of DM patients suffering for a period >2 year but <6 years and Group D comprises patients of uncomplicated DM for a period >10 years. NT–pro-BNP values in plasma are determined by AQT 90 FLEX NT-pro BNP Assay. Blood samples are collected with EDTA as anti-coagulant and plasma is separated. A Roche Modular Analytics E170 immuno assay analyser was used. RESULTS: The results show that the plasma NT-pro-BNP becomes progressively higher in diabetic patients with increased duration of diabetes when compared to the normal healthy controls. The difference in plasma NT-pro-BNP levels of Groups A and D showed a high degree of statistical significance but the difference was not statistically significant in case of Group B and Group C. CONCLUSION: It was found that uncomplicated DM patients of short and moderate duration had greater plasma NT-pro-BNP levels than the age matched non-diabetic healthy group though the difference is not significant. However the levels of NT-pro-BNP in patients of Group D were even higher than Group B and C (Gr A vs. Gr D: p<0.005). Diabetic patients can be periodically checked for NT-pro BNP to detect early onset Diabetic cardiomyopathy or other cardiac disorders as suggested by high NT-pro-BNP levels. KEYWORDS: NT- pro-BNP; Diabetic Cardiomyopathy, Diabetes Mellitus. INTRODUCTION: Cardiomyopathy as per recent definition of the World Health Organization is ventricular dysfunction due to inability to correct volume or pressure overload in valvular diseases, hypertension, coronary artery disease (CAD), Diabetes Mellitus (DM), alcoholism, viral myocarditis and genetic preponderance etc. 1 DM is a not so uncommon cause of cardiomyopathy when the former is particularly long standing and both are becoming increasingly more common. Since NT-pro-BNP and other natriuretic cardiac markers are enhanced in cardiac ailments as noted above, it will not be unreasonable to study NT-pro-BNP levels in diabetic patients particularly when cardiomyopathy is suspected to be setting in. NT- pro-BNP belongs to the natriuretic peptide (NP) family of hormones which contribute to the control of body fluid homeostasis and blood pressure regulation through their combined actions on vasculature, kidneys, and adrenal glands. 2 The best-known members of these families are ANP, 3 BNP, 4 NT-pro-ANP, NT pro-BNP 5,6 and C-type natriuretic peptide (CNP). 7 ANP and BNP are produced predominantly by the cardiac atrium and ventricle respectively in response to increased atrial and