Gender difference of association between plasma N-terminal pro-atrial natriuretic peptide and metabolic syndrome

Hormones (Athens). 2020 Dec;19(4):541-548. doi: 10.1007/s42000-020-00222-w. Epub 2020 Jul 3.


Purpose: The natriuretic peptides (NPs) system, and mainly atrial natriuretic peptide (ANP), plays a key role in human metabolism and cardiometabolic disorders. Due to differences in NP levels and in prevalence of metabolic syndrome (MetS) between men and women, we aimed to explore the gender difference of association between N-terminal pro-atrial natriuretic peptide (NT-proANP) and MetS in a general population in China.

Methods: Participants' weight, height, waist circumference, blood pressure, plasma NT-proANP, and other traditional biomarkers were measured. Multivariate logistic regression models were used to determine the association between plasma NT-proANP and MetS, and the odds ratio (OR) and 95% confidence interval (CI) were calculated for men and women, respectively.

Results: Among 2203 participants, 1361 (61.78%) were women, 687(30.77%) participants had MetS, and the average age was 53 years. Women had a higher level of NT-proANP than men. However, adjusted logistic regression demonstrated that men in the upper quartile group of NT-proANP had 0.60 (95% CI 0.39-0.92) times the risk of having MetS, while women in the upper quartile group had 1.10 (95% CI 0.77-1.56) times the risk of having MetS compared to the lower quartile group. Furthermore, with the increase of the level of NT-proANP, the ORs showed a declining trend in men (P = 0.017), but it was not statistically significant among women (P = 0.700).

Conclusions: There are gender differences in the relationship between NT-proANP and MetS, while an inverse association between plasma NT-proANP and MetS in men suggests that higher levels of NT-proANP may be a protective factor for MetS.

Keywords: Cross-sectional study; Gender-related differences; Metabolic syndrome; Plasma NT-proANP.

MeSH terms

  • Adult
  • Atrial Natriuretic Factor / blood*
  • China / epidemiology
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Protective Factors
  • Sex Characteristics
  • Sex Factors


  • NPPA protein, human
  • Atrial Natriuretic Factor