NT-proBNP blood levels in patients with type 2 diabetes mellitus with anemia and after the dapagliflozin treatment

1Sokolova, LK, 1Pushkarev, VM, 1Belchina, Yu.B, 1Pushkarev, VV, Furmanova, OV, Cherviakova, SA, 1Kovzun, OI, 1Tronko, MD
1V.P. Komisarenko Institute of Endocrinology and Metabolism of the NAMS of Ukraine, Kyiv
Dopov. Nac. akad. nauk Ukr. 2018, 11:91-95
https://doi.org/10.15407/dopovidi2018.11.091
Section: Medicine
Language: English
Abstract: 

The content of the brain natriuretic peptide (NT-proBNP) in blood plasma and the activity of 5′-adenosine monophosphate-activated protein kinase (AMPK) in lymphocytes of type 2 diabetes patients with anemia and after the treatment with dapagliflozin are determined with enzyme immunoassay. It is shown that the highest level of NTproBNP is observed in patients with severe anemia. At the treatment with dapagliflozin, the peptide level was markedly reduced, which may be explained by an increase in the activity of AMPK as a result of the exposure to a hypoglycemic drug. It is suggested that the treatment with dapagliflozin may have a positive effect on complications of type 2 diabetes associated with cardiovascular pathologies.

Keywords: AMPK, anemia, dapagliflozin, NT-proBNP, type 2 diabetes
References: 
  1. Mahadavan, G., Nguyen, T. H. & Horowitz, J. D. (2014). Brain natriuretic peptide: a biomarker for all cardiac disease? Curr. Opin. Cardiol., 29, No. 2, pp. 160-166. doi: https://doi.org/10.1097/HCO.0000000000000036
  2. Goncalves, G. K., Caldeira de Oliveira, T. H. & de Oliveira Belo, N. (2017). Cardiac hypertrophy and brain natriuretic peptide levels in an ovariectomized rat model fed a high-fat diet. Med. Sci. Monit. Basic Res., No. 23, pp. 380-391. doi: https://doi.org/10.12659/MSMBR.907162
  3. Wolsk, E., Claggett, B., Pfeffer, M. A., Diaz, R., Dickstein, K., Gerstein, H. C., Lawson, F. C., Lewis, E. F., Maggioni, A. P., McMurray, J. J. V., Probstfield, J. L., Riddle, M. C., Solomon, S. D., Tardif, J. C. & Køber, L. (2017). Role of B-type natriuretic peptide and N-terminal prohormone BNP as predictors of cardiovascular morbidity and mortality in patients with a recent coronary event and type 2 diabetes mellitus. J. Am. Heart. Assoc., 6, No. 6, e004743. doi: https://doi.org/10.1161/JAHA.116.004743
  4. Wu, A. H., Omland, T., Wold Knudsen, C., McCord, J., Nowak, R. M., Hollander, J. E., Duc, P., Storrow, A. B., Abraham, W. T., Clopton, P., Maisel, A. S., McCullough, P.A. & Breathing Not Properly Multinational Study Investigations. (2005). Relationship of B-type natriuretic peptide and anemia in patients with and without heart failure: a substudy from the Breathing Not Properly (BNP) Multinational Study. Am. J. Hematol., 80, No. 3, pp. 174-180. doi: https://doi.org/10.1002/ajh.20456
  5. Antwi-Bafour, S., Hammond, S., Adjei, J. K., Kyeremeh, R., Martin-Odoom, A. & Ekem, I. (2016). A casecontrol study of prevalence of anemia among patients with type 2 diabetes. J. Med. Case Rep., 10, No. 1, pp. 110. doi: https://doi.org/10.1186/s13256-016-0889-4
  6. Chung, J. O., Park, S. Y., Cho, D. H., Chung, D. J. & Chung, M. Y. (2017). Anemia, bilirubin, and cardiovascular autonomic neuropathy in patients with type 2 diabetes. Medicine (Baltimore)., 96, No. 15, e6586. doi: https://doi.org/10.1097/MD.0000000000006586
  7. Filippatos, T. D., Liberopoulos, E. N. & Elisaf, M. S. (2015). Dapagliflozin in patients with type 2 diabetes mellitus. Ther. Adv. Endocrinol. Metab., 6, No. 1, pp. 29-41. doi: https://doi.org/10.1177/2042018814558243
  8. Saha, A. K., Xu, X. J., Balon, T. W., Brandon, A., Kraegen, E. W. & Ruderman, N. B. (2011). Insulin resistance due to nutrient excess. Is it a consequence of AMPK downregulation? Cell Cycle., 10, No. 20, pp. 3447-3451. doi: https://doi.org/10.4161/cc.10.20.17886
  9. Pushkarev, V. M., Sokolova, L. K., Pushkarev, V. V. & Tronko, N. D. (2016). The role of AMPK and mTOR in the development of insulin resistance and type 2 diabetes. The mechanism of metformin action. Probl. Endocrinol. Pathol., No. 3, pp. 77-90 (in Russsian).
  10. Cai, Y., Zhao, L., Qin, Y. & Wu, X. Q. (2015). EGCG blocked phenylephrin-induced hypertrophy in H9C2 cardiomyocytes, by activating AMPK-dependent pathway. Korean J. Physiol. Pharmacol., 19, No. 3, pp. 203-210. doi: https://doi.org/10.4196/kjpp.2015.19.3.203
  11. Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., Mattheus, M., Devins, T., Johansen, O. E., Woerle, H. J., Broedl, U. C., Inzucchi, S. E., & EMPA-REG OUTCOME Investigators. (2015). Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N. Engl. J. Med., 373, No. 22, pp. 2117-2128. doi: https://doi.org/10.1056/NEJMoa1504720