C-type natriuretic peptide is a pivotal regulator of metabolic homeostasis

Proc Natl Acad Sci U S A. 2022 Mar 29;119(13):e2116470119. doi: 10.1073/pnas.2116470119. Epub 2022 Mar 25.


Thermogenesis and adipogenesis are tightly regulated mechanisms that maintain lipid homeostasis and energy balance; dysfunction of these critical processes underpins obesity and contributes to cardiometabolic disease. C-type natriuretic peptide (CNP) fulfills a multimodal protective role in the cardiovascular system governing local blood flow, angiogenesis, cardiac function, and immune cell reactivity. Herein, we investigated a parallel, preservative function for CNP in coordinating metabolic homeostasis. Global inducible CNP knockout mice exhibited reduced body weight, higher temperature, lower adiposity, and greater energy expenditure in vivo. This thermogenic phenotype was associated with increased expression of uncoupling protein-1 and preferential lipid utilization by mitochondria, a switch corroborated by a corresponding diminution of insulin secretion and glucose clearance. Complementary studies in isolated murine and human adipocytes revealed that CNP exerts these metabolic regulatory actions by inhibiting sympathetic thermogenic programming via Gi-coupled natriuretic peptide receptor (NPR)-C and reducing peroxisome proliferator-activated receptor-γ coactivator-1α expression, while concomitantly driving adipogenesis via NPR-B/protein kinase-G. Finally, we identified an association between CNP/NPR-C expression and obesity in patient samples. These findings establish a pivotal physiological role for CNP as a metabolic switch to balance energy homeostasis. Pharmacological targeting of these receptors may offer therapeutic utility in the metabolic syndrome and related cardiovascular disorders.

Keywords: G protein–coupled receptor; adipogenesis; cardiometabolic disease; natriuretic peptide; thermogenesis.

MeSH terms

  • Animals
  • Atrial Natriuretic Factor
  • Cardiovascular Diseases / metabolism
  • Homeostasis*
  • Metabolic Diseases / metabolism
  • Mice
  • Mice, Knockout
  • Natriuretic Peptide, C-Type* / genetics
  • Natriuretic Peptide, C-Type* / physiology
  • Receptors, Atrial Natriuretic Factor / metabolism
  • Thermogenesis*


  • Natriuretic Peptide, C-Type
  • Atrial Natriuretic Factor
  • Receptors, Atrial Natriuretic Factor