{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:19Z","timestamp":1792384879791,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010Pro BNP) is an established biomarker of heart failure and has been recommended for cardiovascular risk stratification in type 2 diabetes mellitus (T2DM). However, its relationship with diabetic nephropathy and endothelial dysfunction across varying stages of kidney impairment remains unclear. This study examined the associations of NT\u2010Pro BNP, renal impairment, albuminuria and endothelial dysfunction in patients with T2DM without overt heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A comparative cross\u2010sectional study was conducted among 192 adults with T2DM. Participants were stratified by KDIGO eGFR groups (\u2265\u200990, 60\u201389, 30\u201359\u2009mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      ). NT\u2010Pro BNP was considered abnormal at a cut\u2010off of \u2265\u2009125\u2009pg\/mL. Albuminuria was categorized using the urinary albumin\u2010to\u2010creatinine ratio (uACR). Endothelial function was assessed by brachial artery flow\u2010mediated dilatation (FMD). Logistic regression analysis was performed to identify independent factors of elevated NT\u2010Pro BNP, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2010values &lt;\u20090.05 considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      NT\u2010Pro BNP levels were significantly higher in the lower eGFR groups compared with normal eGFR (204.3 vs. 96.8 vs. 62.2\u2009pg\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090001). A weak but significant positive correlation was observed between NT\u2010Pro BNP and uACR (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, no significant association was found between NT\u2010Pro BNP and FMD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.388). Following multivariable adjustments, older age (adjusted OR 1.14, 95% CI: 1.06\u20131.23,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), higher systolic blood pressure (adjusted OR 1.05, 95% CI: 1.02\u20131.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), lower eGFR (adjusted OR 0.97, 95% CI: 0.95\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and beta\u2010blocker use (adjusted OR 4.65, 95% CI: 1.61\u201313.45,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u20090.001) were independently associated with elevated NT\u2010Pro BNP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with T2DM without overt heart failure, elevated NT\u2010Pro BNP showed a statistically significant association with lower eGFR and higher albuminuria. Moderate to severe albuminuria becomes an independent factor for elevated NT\u2010Pro BNP after adjustment excluding eGFR. The lack of association with endothelial dysfunction suggests that NT\u2010Pro BNP may reflect different pathophysiological pathways. NT\u2010Pro BNP may serve as a useful biomarker for early cardiovascular risk stratification and identification of individuals at risk of pre\u2013heart failure in diabetic kidney disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71258","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:21:57Z","timestamp":1788254517000},"page":"10683-10695","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between\n                    <scp>NT<\/scp>\n                    \u2010Pro\n                    <scp>BNP<\/scp>\n                    , Nephropathy and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9279-0006","authenticated-orcid":false,"given":"Nursyahirah","family":"Ishak","sequence":"first","affiliation":[{"name":"Endocrine Unit, Department of Internal Medicine, Faculty of Medicine Universiti Teknologi MARA  Sungai Buloh Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur ' Aini","family":"Eddy Warman","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Internal Medicine, Faculty of Medicine Universiti Teknologi MARA  Sungai Buloh Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja Ezman Faridz","family":"Raja Shariff","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Universiti Teknologi MARA  Sungai Buloh Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin Wee","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Public Health Medicine, Faculty of Medicine Universiti Teknologi MARA  Sungai Buloh Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3520-8472","authenticated-orcid":false,"given":"Rohana","family":"Abdul Ghani","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Internal Medicine, Faculty of Medicine Universiti Teknologi MARA  Sungai Buloh Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"International Diabetes Federation \u201cIDF Diabetes Atlas \u201daccessed February 20 2026 https:\/\/diabetesatlas.org\/resources\/idf\u2010diabetes\u2010atlas\u20102025\/."},{"key":"e_1_2_15_3_1","volume-title":"National Health and Morbidity Survey (NHMS) 2023: Fact Sheet","author":"Institute for Public Health (IPH)","year":"2023"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-02995-z"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.311586"},{"key":"e_1_2_15_6_1","first-page":"118","article-title":"The Impact of Diabetes on Cardiac Structure and Function: A Meta\u2010Analysis","volume":"9","author":"Paolillo S.","year":"2019","journal-title":"Iris"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1170"},{"key":"e_1_2_15_8_1","first-page":"1027","article-title":"Pre\u2013Heart Failure: An Important Opportunity to Prevent a Deadly Disease","volume":"11","author":"Bozkurt B.","year":"2023","journal-title":"Journal of Cardiac Failure"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1741826711420015"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.025"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.37349\/eemd.2024.00013"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.12.012"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001184"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241310705"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-018-0821-9"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.39"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-1-201101040-00003"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2014.03.003"},{"key":"e_1_2_15_20_1","first-page":"S1","article-title":"Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification","volume":"3","author":"Kidney Disease Outcomes Quality Initiative (KDOQI)","year":"2002","journal-title":"Kidney International. 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