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Journal of The Korean Society of Emergency Medicine 2021;32(6): 575-585. |
| 폐렴에서 체질량 지수가 N-terminal pro-B-type natriuretic peptide의 예후 예측 능력에 미치는 영향: 정상 체중과 비만 성인 사이의 비교 연구 |
김형석, 정기영
, 최한성
, 홍훈표, 이종석
, 고석훈
, 김성규
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| 경희대학교병원 응급의학과 |
| Effect of body mass index on the prognostic value of N-terminal pro-B-type natriuretic peptide in pneumonia: a comparative study between normal-weight and obese adults |
| Hyung Seok Kim, Ki Young Jeong
, Han Sung Choi
, Hoon Pyo Hong, Jong Seok Lee
, Seok Hun Ko
, Sung Kyu Kim
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| Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Korea |
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Received: August 18, 2020; Revised: October 16, 2020 Accepted: October 30, 2020. Published online: December 31, 2021. |
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| ABSTRACT |
Objective:
Body mass index (BMI) is a major determinant of N-terminal pro-brain natriuretic peptide (NT-proBNP). However, the relationship of BMI with pneumonia has not been entirely characterized.
Method:
Adult patients with pneumonia, who visited the emergency department from January 2017 to December 2019, were included. According to BMI, they were divided into two groups, including normal-weight and obesity groups. Data were retrospectively reviewed via the prospectively collected pneumonia registry and medical chart. NT-proBNP, BMI and pneumonia severity index (PSI) were determined for all subjects. The moderating effect between NT-proBNP and BMI was examined by entering interaction terms into the multivariable regression model predicting mortality. Using the area under the curve (AUC), the predictive performance of NT-proBNP was evaluated.
Results:
Of 327 enrolled patients, 118 patients belonged to the obesity group. In a multivariable model including BMI, NT-proBNP was identified as an independent predictor of mortality. The AUC of the adjusted NT-proBNP including BMI, significantly increased the AUC of the adjusted NT-proBNP excluding BMI and tended to be superior to that of PSI. A positively significant BMI-by-NT-proBNP interaction for mortality was observed. NT-proBNP showed significant prognostic power in both BMI groups, but NT-proBNP of the obesity group had significantly higher AUC than that of the normalweight group. In the obesity group, the AUC of NT-proBNP tended to be higher than that of PSI.
Conclusion:
BMI is a significant factor enhancing the prognostic power of NT-proBNP in pneumonia. The prognostic utility of NT-proBNP was significantly differed by BMI groups, which is more useful in the obesity group than the normalweight group. |
| Key words:
Pneumonia; Natriuretic peptides; Body mass index; Prognosis |
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