Serum N-terminal-pro-B-type natriuretic peptide is dependent on age and sex: a cross-sectional analysis in healthy adults from Northeast China

Abstract Background: Previous studies suggested higher serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level with older age and in women, but the reference intervals (RIs) recommended by assay manufacturers do not fully recognize such pattern. Aims: In this study, we aimed to establish a set of age- and sex-specific RIs for serum NT-proBNP in healthy adults from Northeast China. Methods: Healthy adult subjects (20 to ≤95 years old) were recruited from the physical examination center at a teaching hospital during a period from March 2020 to July 2020. Serum NT-proBNP concentration was measured using the VITROS 5600 Integrated System with a chemiluminescence method. RIs were calculated based on the EP28-A3c guidelines by the Clinical and Laboratory Standards Institute. A generalized linear model was performed to factors that were associated with NT-proBNP level. Results: The final analysis included 2,183 subjects (1,074 men and 1,109 women, mean age 54.2 ± 19.5 years). Serum NT-proBNP level increased with advancing age (20 to <50, 50 to <60, 60 to <75 and ≥75 years), and was significantly higher in women than in men with the exception of the ≥75 age group. Higher NT-proBNP level was associated with the female sex, older age, lower body mass index, higher urea nitrogen, higher creatinine, lower uric acid, and lower triglyceride (P < 0.05 for all). The strongest association was with the female sex, followed by age. Conclusions: Serum NT-proBNP level must be interpreted with consideration of sex and age. Higher NT-proBNP is associated with the female sex and older age.