Rationale: B type natriuretic peptide (BNP) is a hormone released from cardiomyocytes in
response to myocyte stretching and serves as a reliable biomarker in the diagnosis of cardiac
dysfunction and heart failure. Recent observations speak for a distinct connection between
chronic heart failure and diabetes mellitus.
Objective: The study was set out to investigate the role of BNP on parameters of glucose
metabolism in a placebo controlled cross-over study in healthy volunteers.
Methods and Results: Ten participants (25±1 years; BMI 23±1 kg/m2; fasting glucose 83±2
mg/dL) received either placebo or 3 pmol/kg/min BNP 32 intravenously for 4h. One hour after
beginning the BNP/placebo infusion, a 3h intravenous glucose tolerance test (0.33 g/kg
glucose + 0.03 U/kg insulin at 20 min) was performed and plasma glucose, insulin and C
peptide were frequently measured. BNP increased the initial glucose distribution volume (13±1
%BW vs. 11±1, P<0.002), leading to an overall reduction of glucose concentration (P<0.001)
especially during the initial 20 min of the test (P=0.001), accompanied by a reduction of the
initial C peptide levels (4.3±0.4 ng/mL vs. 4.9±0.3, P=0.015). BNP had no impact on beta cell
function, insulin clearance or insulin sensitivity.
Discussion: Intravenous administration of BNP increases glucose initial distribution volume
and lowers plasma glucose concentrations after a glucose load without affecting beta cell
function or insulin sensitivity what speaks for the concept that BNP is not diabetogenic, but
improves the metabolic status in patients with heart failure. This opens new questions
regarding BNP induced differences in glucose availability and signalling in several