Proneurotensin Predicts Cardiovascular Disease in an Elderly Population

J Clin Endocrinol Metab. 2018 May 1;103(5):1940-1947. doi: 10.1210/jc.2017-02424.


Context: The gut hormone neurotensin promotes fat absorption, diet-induced weight gain, and liver steatosis. Its stable precursor-hormone fragment "proneurotensin" predicts cardiometabolic disease in middle-aged populations, especially in women.

Objective: To test if proneurotensin predicts cardiovascular disease (CVD) and diabetes development in an elderly population and whether there are gender differences in this respect.

Design, setting, and participants: Fasting proneurotensin was measured in plasma from 4804 participants (mean age 69 ± 6 years) of the Malmö Preventive Project and subjects were followed up for development of CVD and diabetes during 5.4 years.

Main outcome measures: Multivariate adjusted Cox proportional hazard models CVD were used to relate the proneurotensin to the risk of incident CVD and diabetes in all subjects and in gender-stratified analyses.

Results: In total, there were 456 first CVD events and 222 incident cases of diabetes. The hazard ratio [HR (95% confidence interval)] for CVD per 1 standard deviation (SD) increment of proneurotensin was 1.10 (1.01 to 1.21); P = 0.037, and the above vs below median HR was 1.27 (1.06 to 1.54); P = 0.011, with similar effect sizes in both genders. There was no significant association between proneurotensin and incident diabetes in the entire population (P = 0.52) or among men (P = 0.52). However, in women proneurotensin predicted diabetes incidence with a per 1 SD increment HR of 1.28 (1.30 to 1.59); P = 0.025 and an above vs below median HR of 1.41 (1.10 to 1.80); P = 0.007.

Conclusions: In the elderly population, proneurotensin independently predicts development of CVD in both genders, whereas it only predicts diabetes in women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diagnostic Techniques, Endocrine
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Humans
  • Male
  • Middle Aged
  • Neurotensin / blood*
  • Prognosis
  • Protein Precursors / blood*
  • Sex Factors


  • Biomarkers
  • Protein Precursors
  • proneurotensin
  • Neurotensin