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B-type natriuretic peptide (BNP) and the amino-terminal fragment of its prohormone (NT-proBNP) are commonly used for heart failure screening and diagnosis, but biologically BNP exerts several beneficial cardiovascular effects primarily by counteracting the renin-angiotensin-aldosterone-system. We asked whether ethnic differences in circulating NT-proBNP levels could be explained by the differences in cardiometabolic and inflammatory risk markers?<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We examined 162 South Asian and 107 Nordic women in Norway 1\u20133 years after GDM with a clinical examination, fasting blood samples and an oral glucose tolerance test. We measured the levels of NT-proBNP, high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), leptin, adiponectin and markers of insulin sensitivity, such as the Matsuda insulin sensitivity index (ISI). Finally, we tried to identify which independent covariate best mediated the ethnic differences in NT-proBNP.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean (SD) age was 35.3 (4.5) years, BMI 29.1 (6.0) kg\/m<jats:sup>2<\/jats:sup>, waist-height ratio 0.60 (0.08) and 164 women (61%) had prediabetes\/diabetes. Notably, South Asian women had lower levels of NT-proBNP than Nordic women in both the normoglycemic and prediabetes\/diabetes groups (median (IQR) 26\u00a0\u00a0(15\u201338) \u00a0vs. 42 (22\u201366) ng\/L, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Higher NT-proBNP levels were associated with greater insulin sensitivity in both South Asian and Nordic women (<jats:italic>p<\/jats:italic>\u2009=\u20090.005 and <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). South Asian women had higher levels of hsCRP (median (IQR) 2.2 (1.1\u20134.4) vs. 1.2 (0.3\u20134.2) mg\/L), IL-6 (2.3 (1.5\u20133.2) vs. 1.5 (1.5\u20132.5) pg\/mL), leptin (1647 (1176\u20132480) vs. 1223 (876\u20132313) pmol\/L), and lower adiponectin levels (7.2 (5.3\u20139.3) vs. 10.0 (7.2\u201313.5) mg\/L) and Matsuda ISI (2.4 (1.7\u20133.7) vs. 4.2 (2.9\u20136.1), p<jats:sub>all<\/jats:sub>&lt;0.01) than Nordic women. Even after adjusting for these differences, higher NT-proBNP levels remained associated with insulin sensitivity (22% higher NT-proBNP per SD Matsuda ISI, <jats:italic>p<\/jats:italic>\u2009=\u20090.015). Insulin sensitivity and adiponectin mediated 53% and 41% of the ethnic difference in NT-proBNP.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>NT-proBNP levels are lower in South Asian than in Nordic women after GDM. Lower NT-proBNP levels correlate with impaired insulin sensitivity. Lower NT-proBNP levels in South Asian women could, therefore, be attributed to impaired insulin sensitivity rather than total body fat.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12933-024-02349-1","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T13:02:06Z","timestamp":1722690126000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["N-terminal pro-B-type natriuretic peptide levels vary by ethnicity and are associated with insulin sensitivity after gestational diabetes mellitus"],"prefix":"10.1186","volume":"23","author":[{"given":"Archana","family":"Sharma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e5re I.","family":"Birkeland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Nermoen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Sommer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Qvigstad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindre","family":"Lee-\u00d8deg\u00e5rd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari A.","family":"Sveen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naveed","family":"Sattar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stina T.","family":"Sollid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torbj\u00f8rn","family":"Omland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peder L.","family":"Myhre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"issue":"1","key":"2349_CR1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000000593","volume":"138","author":"S Volgman Annabelle","year":"2018","unstructured":"Volgman Annabelle S, Palaniappan Latha S, Aggarwal Neelum T, Gupta M, Khandelwal A, Krishnan Aruna V, et al. 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