High N‐Terminal Pro‐B‐Type Natriuretic Peptide Levels Are Associated With Lower Physical Function Independent of Sarcopenia in Community‐Dwelling Older Adults: The Shizuoka Study

AIMS: Higher levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) have been shown to be associated with muscle deterioration and lower physical performance among patients with heart failure (HF). The aim of this study was to clarify the relationships between NT-proBNP levels, sarcopenia, and physical function among community-dwelling older adults. METHODS: This study included 2793 community-dwelling older adults without overt HF symptoms (mean age: 74 ± 4 years; 54% women) who participated in a community-based study. NT-proBNP levels were measured and categorized into four groups: < 125, 125-299, 300-899, and ≥ 900 pg/mL. Sarcopenia was determined according to the skeletal muscle mass index (SMI) and handgrip strength, while usual gait speed and five-times sit-to-stand (5-STS) time were assessed as indicators of physical function. Bioimpedance phase angle was assessed as an indicator of muscle quality. RESULTS: In logistic regression analyses, NT-proBNP ≥ 900 pg/mL was significantly associated with low gait speed [odds ratio (OR): 2.79, 95% confidence interval (CI): 1.08-7.20] and prolonged 5-STS time (OR: 3.71, 95% CI: 1.49-9.20). These associations were consistent for both men and women and remained significant after exclusion of participants with heart disease and after adjustment for sarcopenia. In contrast, high NT-proBNP levels were not significantly associated with low SMI (OR: 1.34, 95% CI: 0.54-3.32), handgrip strength (OR: 1.32, 95% CI: 0.65-2.34), or sarcopenia (OR: 1.45, 95% CI: 0.53-4.01). A significant trend of a decreasing phase angle (p < 0.001) with increasing NT-proBNP levels was observed. CONCLUSION: High NT-proBNP levels were associated with lower physical function independent of sarcopenia among community-dwelling older adults. The lower physical function observed among participants with high NT-proBNP levels may be associated with reduced muscle quality.