diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13367diaendo-13367Research ArticleОбзорыReviewКлиническое значение мониторинга мозгового натрийуретического пептида и N-концевого промозгового натрийуретического пептида при сахарном диабете 2 типаClinical significance of brain natriuretic peptide and N-terminal pro-brain natriuretic peptide monitoring in type 2 diabetes mellitushttps://orcid.org/0000-0003-4641-3874БондарьИ. А.BondarI. A.

Бондарь Ирина Аркадьевна, д.м.н., профессор 

Новосибирск 

Irina A. Bondar, MD, PhD, Professor 

Novosibirsk 

irinaabondar@yandex.ruhttps://orcid.org/0000-0003-1052-1451ДеминА. А.DeminA. A.

Демин Александр Аристархович, д.м.н., профессор 

Новосибирск 

Alexandr A. Demin, MD, PhD, Professor 

Novosibirsk 

alexdemin2006@yandex.ruhttps://orcid.org/0000-0002-6219-1426ГражданкинаД. В.GrazhdankinaD. V.

Гражданкина Дарья Владимировна, к.м.н., ассистент 

Новосибирск 

Darya V. Grazhdankina, MD, PhD 

52 Krasny Prospect, 630091 Novosibirsk 

graghdankina@rambler.ruhttps://orcid.org/0009-0007-7626-7122КраснопевцеваИ. П.KrasnopevtsevaI. P.

Краснопевцева Ирина Петровна, к.м.н. 

Новосибирск 

Irina P. Krasnopevtseva, MD, PhD 

Novosibirsk 

k.i.p@ngs.ruНовосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian Federation202503122025285471479Copyright © Бондарь И.А., Демин А.А., Гражданкина Д.В., Краснопевцева И.П., 20252025Бондарь И.А., Демин А.А., Гражданкина Д.В., Краснопевцева И.П.Bondar I.A., Demin A.A., Grazhdankina D.V., Krasnopevtseva I.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13367

Мозговой натрийуретический пептид (BNP) и N-концевой промозговой натрийуретический пептид (NT-proBNP) - это полипептидные гормоны, высвобождаемые кардиомиоцитами в ответ на перегрузку сердца объемом или давлением. Результаты многочисленных исследований продемонстрировали значимость данных биомаркеров для диагностики хронической сердечной недостаточности (ХСН), в том числе у больных сахарным диабетом 2 типа (СД2). Также показано, что повышение уровня BNP/NT-proBNP ассоциировано с неблагоприятным прогнозом, а снижение уровня биомаркеров в динамике может приводить к уменьшению частоты фатальных и нефатальных сердечно-сосудистых исходов, а также смерти от любых причин. На сегодняшний день предметом дискуссии остаются пороговые значения BNP/NT-proBNP для диагностики ХСН, особенно фенотипа ХСН с сохраненной фракцией выброса левого желудочка (ХСНсФВ), так как на уровень данных биомаркеров может оказывать влияние возраст, индекс массы тела (ИМТ), функция почек, инсулинорезистентность, острое и хроническое воспаление. Целью данного обзора является обобщение существующих данных о клиническом значении мониторинга BNP/NT-proBNP с акцентом на больных СД2 и о факторах, которые могут оказывать влияние на концентрацию данных биомаркеров в крови.  Использование индивидуальных пороговых значений BNP/NT-proBNP для повышения точности диагностики как бессимптомной дисфункции сердца, так и  явной ХСН представляет перспективу для дальнейших исследований.

Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are polypeptide hormones released by cardiomyocytes in response to cardiac volume or pressure overload. The results of numerous studies have demonstrated the importance of these biomarkers for the diagnosis of chronic heart failure (CHF), including studies in patients with type 2 diabetes mellitus (T2DM). It has also been shown that the elevated BNP/NT-proBNP levels are associated with an unfavorable prognosis, and a decrease in the level of biomarkers over time can lead to a reduced incidence of fatal and non-fatal cardiovascular outcomes, as well as death from any cause. To date, the threshold values of BNP/NT-proBNP for the diagnosis of CHF, especially the phenotype of CHF with preserved left ventricular ejection fraction (CHFpEF), remain a subject of discussion, since the level of these biomarkers can be influenced by age, body mass index (BMI), kidney function, insulin resistance, acute and chronic inflammation. The aim of this review is to summarize the existing data on the clinical significance of BNP/ NT-proBNP monitoring with a focus on patients with T2DM and on factors that may influence the concentration of these biomarkers in the blood. The use of individual BNP/NT-proBNP cut-off values to improve the diagnostic accuracy of both asymptomatic cardiac dysfunction and overt CHF represents a promising area for further research.

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The authors declare that there are no conflicts of interest present.