Journal Article

DZNE-2026-01116

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Meal-induced changes in cardiometabolic peptides in the context of acute cardiovascular diseases and glucose metabolism.

Lishkova, G. ; Schweizerhof, O. ; Großmann, J. ; von Rohr, K. ; Landmesser, U. ; Edelmann, F. ; Eckardt, K. U. ; Endres, M.DZNE* ; Weber, J. E. ; Grittner, U. ; Pischon, T. ; Schulz-Menger, J. ; Müller, D. N. ; Spranger, J. ; Li, L. ; Mai, K. ; Group, B. S. (Collaboration Author) ; Ahmadi, M. (Contributor) ; Boldt, L. H. (Contributor) ; Eckardt, K. U. (Contributor) ; Edelmann, F. (Contributor) ; Endres, M. (Contributor) ; Gerhardt, H. (Contributor) ; Grittner, U. (Contributor) ; Heege, J. (Contributor) ; Hilgendorf, I. (Contributor) ; Hübner, N. (Contributor) ; Landmesser, U. (Contributor) ; Mai, K. (Contributor) ; Müller, D. N. (Contributor) ; Nolte, C. H. (Contributor) ; Pinto, R. M. (Contributor) ; Piper, S. K. (Contributor) ; Pischon, T. (Contributor) ; Rattan, S. (Contributor) ; Rohrpasser-Napierkowski, I. (Contributor) ; Schönrath, K. (Contributor) ; Schulz-Menger, J. (Contributor) ; Schweizerhof, O. (Contributor) ; Weber, J. E. (Contributor)

2026
BioMed Central London

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Please use a persistent id in citations: doi:10.1186/s12933-026-03424-5

Abstract: Natriuretic peptides (NPs) and copeptin are established cardiovascular biomarkers which can partly affect human metabolism. However, impact of human metabolism on their postprandial regulation in high-risk patients remains insufficiently understood. We aimed to characterize meal-induced changes in MR-proANP, NT-proBNP, and copeptin and to assess how these dynamics relate to acute cardiovascular (CV) events, type 2 diabetes (T2D) and insulin resistance (IR).Within the BeLOVE cohort, a subset of 373 participants with acute coronary syndrome, stroke or very high chronic CV risk underwent standardized study-specific mixed-meal testing approximately 3 months after the acute event or 1 month after enrollment for the chronic high-risk group. Fasting and 120-min postprandial concentrations of MR-proANP, NT-proBNP, copeptin, insulin and glucose were assessed. Structural equation models were used to evaluate direct and indirect associations of acute CV events, T2D, and IR (HOMA-IR) with fasting levels and postprandial changes, adjusted for age, sex and BMI.MR-proANP showed the most pronounced meal-induced suppression. NT-proBNP demonstrated only minor and inconsistent postprandial changes. For all peptides, fasting concentrations were the main determinant of their postprandial changes. A recent acute CV event was associated with higher fasting NP levels (MR-proANP: standardized β = 0.22 [0.09; 0.34]; NT-proBNP: β = 0.28 [0.15; 0.41]), but not substantially with their postprandial changes after accounting for their baseline levels. T2D showed no consistent association with fasting or postprandial NP responses. In contrast, higher HOMA-IR was associated with lower fasting MR-proANP (β=-0.19 [-0.30; -0.07]) and a stronger postprandial decline (β=-0.18 [-0.33; -0.04]). Similarly, higher HOMA-IR was linked to lower fasting NT-proBNP (β=-0.15 [-0.28; -0.03]) but showed no clear association to its postprandial change. Copeptin dynamics were largely independent of acute CV disease and metabolic status.In patients after a recent ACS or stroke, postprandial MR-proANP dynamics are linked to insulin resistance, rather than diabetes status. In contrast, the limited postprandial variability of NT-proBNP and the largely fasting-related changes of copeptin make these markers less suited for capturing short-term metabolic responses. Together, these findings highlight the value of postprandial phenotyping for understanding cardiometabolic regulation and support further evaluation of MR-proANP as a potential biomarker in future prospective studies with cardiovascular outcomes across subjects with and without acute CV event.The study protocol was approved by the institutional ethics committee (EA1/066/17) and registered in the German Clinical Trials Register (DRKS00016852).

Keyword(s): Humans (MeSH) ; Glycopeptides: blood (MeSH) ; Female (MeSH) ; Biomarkers: blood (MeSH) ; Male (MeSH) ; Postprandial Period (MeSH) ; Peptide Fragments: blood (MeSH) ; Blood Glucose: metabolism (MeSH) ; Middle Aged (MeSH) ; Atrial Natriuretic Factor: blood (MeSH) ; Insulin Resistance (MeSH) ; Aged (MeSH) ; Diabetes Mellitus, Type 2: blood (MeSH) ; Diabetes Mellitus, Type 2: diagnosis (MeSH) ; Diabetes Mellitus, Type 2: epidemiology (MeSH) ; Time Factors (MeSH) ; Cardiovascular Diseases: diagnosis (MeSH) ; Cardiovascular Diseases: blood (MeSH) ; Natriuretic Peptide, Brain: blood (MeSH) ; Insulin: blood (MeSH) ; Meals (MeSH) ; Risk Assessment (MeSH) ; Glycopeptides ; Biomarkers ; copeptins ; Peptide Fragments ; Blood Glucose ; pro-brain natriuretic peptide (1-76) ; Atrial Natriuretic Factor ; Natriuretic Peptide, Brain ; Insulin ; midregional pro-atrial natriuretic peptide, human

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Contributing Institute(s):

1. Interdisciplinary Dementia Research (AG Endres)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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