Association of N‐terminal pro‐B natriuretic peptide with all‐cause mortality and cardiovascular mortality in obese and non‐obese populations and the development of a machine learning prediction model: National Health and Nutrition Examination Survey (NHANES) 1999–2004
Authors' conclusion
The study showed that NTproBNP can serve as a predictive factor for all-cause mortality and cardiovascular mortality in individuals with different BMIs, including obese individuals. However, significant cardiovascular mortality correlation was observed only for NTproBNP levels ≥300 pg/mL, and only among participants with abdominal obesity.
Study context
- Population
- NHANES participants without HF, 1999–2004, with and without obesitywithout HF
- Participants
- 6,772 participants
- Exposure
- N-terminal pro-B natriuretic peptide (NTproBNP) ≥300 pg/mL vs lower levels
- Outcome
- All-cause mortality and cardiovascular mortality
Methodological detailsNHANES 1999–2004, multivariable Cox regression, restricted cubic spline, Kaplan-Meier curves, seven machine learning methods
- NHANES 1999–2004
- Multivariable Cox regression
- Restricted cubic spline
- Kaplan-Meier curves
- Seven machine learning methods
Main finding
As reported in the abstract
Each group vs NTproBNP <300 pg/mLEstimate (95% CI)
NTproBNP ≥300 pg/mL
HR (all-cause mortality) 3.00(2.48–3.67)
NTproBNP ≥300 pg/mL
HR (cardiovascular mortality) 6.05(3.67–9.97)
- Deaths during follow-up
- 1554
- Cardiovascular deaths
- 365
Observational data: associations, not effects.
Further findings
Without abdominal obesity
- Correlation between NTproBNP and cardiovascular mortality significantly reduced
Machine learning prediction (logistic regression best of seven methods)
- AUC, all-cause mortality
- 0.86925
- AUC, cardiovascular mortality
- 0.85115
- Accurate cardiovascular mortality prediction for non-abdominal obese individuals proved challenging
Original publication
Association of N‐terminal pro‐B natriuretic peptide with all‐cause mortality and cardiovascular mortality in obese and non‐obese populations and the development of a machine learning prediction model: National Health and Nutrition Examination Survey (NHANES) 1999–2004. Diabetes Obes Metab. Published 6 September 2024. doi:10.
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