Association between Elevated N-Terminal Pro-Brain Natriuretic Peptide and Cardiovascular Complication among Type-2 Diabetic Patients in Gaza Strip

The number of patients with type -2 diabetes (T2DM) with cardiovascular complication is progressively increasing all over the world. The burden of T2DM with cardiovascular complication is now a huge Palestinian public health challenge increase substantially in the last two decades. The natriuretic peptide is important in controlling blood pressure and saltwater balance. B-Type Natriuretic Peptide (BNP) and N-Terminal pro-B-Type Natriuretic Peptide (NT-proBNP) are small peptides that are either hormones or part of the peptide that contained the hormone at one time. They are continually produced in small quantities in the heart and released in larger quantities when the heart senses that it needs to work harder. The aim of the study was to investigate association between elevated N-terminal pro-brain natriuretic peptide and cardiovascular complication among Type-2 diabetic patients in Gaza strip. Method: The study design was case-control consist of 180 participants aged 45 to 65 years divided into three groups. The first group is 60 healthy participants as control (group 1) attending Al-Remal central clinic, Gaza. The second group was 60 participants with T2DM without CVD (group 2) who also attending at AlRemal central clinic and last group were T2DM with the cardiovascular complication at the Cardio Care Unit (CCU) at ElShifa hospital (group 3). Three groups were matched for age and the period of study was from June to October 2018. All subjects were investigated for biochemical markers, serum NT-BNP were determined By ELISA techniques. Results: The results pointed out that there was a significant difference between three studied groups in the gender, BMI, smoking, and level of hypertension (P<0.05). Also, the results illustrated that patients T2DM with CVD complication were higher statistically significant of duration and age at onset than T2DM without CVD patients. The results of the study showed that the average of NT-BNP level was higher statistically significant in T2DM with CVD compared without CVD and controls. In contrast, no statistically significant for NT-BNP level T2DM with CVD and without CVD. By same away, the mean of cardiac enzymes (LDH, CK & CKMB) were higher statistically significant in T2DM with CVD compared with T2DM without CVD and controls (P<0.001). However, the results showed that there is a positive significant correlation between NT-BNP and BMI, Blood pressure (Systolic and Diastolic), CKMB and LDH (P<0.05). Conclusion: Results of this study recommended that serum NT-BNP not utility as a cardiac biomarker in CVDs predication in T2DM patients. And there are positive association between NT-BNP and BMI, Blood pressure (Systolic and Diastolic), CKMB and LDH.