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Differential response of the natriuretic peptide system to weight loss and exercise in overweight or obese patients

Item Type:Article
Title:Differential response of the natriuretic peptide system to weight loss and exercise in overweight or obese patients
Creators Name:Haufe, S. and Kaminski, J. and Utz, W. and Haas, V. and Mähler, A. and Daniels, M.A. and Birkenfeld, A.L. and Lichtinghagen, R. and Luft, F.C. and Schulz-Menger, J. and Engeli, S. and Jordan, J.
Abstract:OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Keywords:Adipose Tissue, Atrial Natriuretic Peptide, Natriuretic Peptide Receptor, Obesity, Weight Loss
Source:Journal of Hypertension
Publisher:Lippincott Williams & Wilkins
Page Range:1458-1464
Date:July 2015
Official Publication:https://doi.org/10.1097/HJH.0000000000000573
PubMed:View item in PubMed

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