{
  "abstract": "Background: Natriuretic peptides (NPs) and copeptin are established cardiovascular biomarkers which can partly affect human metabolism. However, impact of human metabolism on their postprandial regulation in high-risk patients remains insufficiently understood. We aimed to characterize meal-induced changes in MR-proANP, NT-proBNP, and copeptin and to assess how these dynamics relate to acute cardiovascular (CV) events, type 2 diabetes (T2D) and insulin resistance (IR).\n\nMethods: Within the BeLOVE cohort, a subset of 373 participants with acute coronary syndrome, stroke or very high chronic CV risk underwent standardized study-specific mixed-meal testing approximately 3 months after the acute event or 1 month after enrollment for the chronic high-risk group. Fasting and 120-min postprandial concentrations of MR-proANP, NT-proBNP, copeptin, insulin and glucose were assessed. Structural equation models were used to evaluate direct and indirect associations of acute CV events, T2D, and IR (HOMA-IR) with fasting levels and postprandial changes, adjusted for age, sex and BMI.\n\nResults: MR-proANP showed the most pronounced meal-induced suppression. NT-proBNP demonstrated only minor and inconsistent postprandial changes. For all peptides, fasting concentrations were the main determinant of their postprandial changes. A recent acute CV event was associated with higher fasting NP levels (MR-proANP: standardized β = 0.22 [0.09; 0.34]; NT-proBNP: β = 0.28 [0.15; 0.41]), but not substantially with their postprandial changes after accounting for their baseline levels. T2D showed no consistent association with fasting or postprandial NP responses. In contrast, higher HOMA-IR was associated with lower fasting MR-proANP (β=−0.19 [−0.30; −0.07]) and a stronger postprandial decline (β=−0.18 [−0.33; −0.04]). Similarly, higher HOMA-IR was linked to lower fasting NT-proBNP (β=−0.15 [−0.28; −0.03]) but showed no clear association to its postprandial change. Copeptin dynamics were largely independent of acute CV disease and metabolic status.\n\nConclusions: In patients after a recent ACS or stroke, postprandial MR-proANP dynamics are linked to insulin resistance, rather than diabetes status. In contrast, the limited postprandial variability of NT-proBNP and the largely fasting-related changes of copeptin make these markers less suited for capturing short-term metabolic responses. Together, these findings highlight the value of postprandial phenotyping for understanding cardiometabolic regulation and support further evaluation of MR-proANP as a potential biomarker in future prospective studies with cardiovascular outcomes across subjects with and without acute CV event.\n\nTrial registration: The study protocol was approved by the institutional ethics committee (EA1/066/17) and registered in the German Clinical Trials Register (DRKS00016852).\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12933-026-03424-5.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Endocrinology and Metabolism, Charité-Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Berlin, ENDO-ERN, Berlin, Germany",
    "German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany",
    "German Center for Diabetes Research (DZD), München-Neuherberg, Germany",
    "Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany",
    "Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany",
    "Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care Medicine, Campus Virchow Klinikum, Berlin, Germany",
    "Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany",
    "Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany",
    "Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany",
    "Center for Stroke Research (CSB), Charité-Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany",
    "German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany",
    "German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany",
    "Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany",
    "Biobank Technology Platform, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany",
    "Experimental and Clinical Research Center, A Cooperation of Charité- Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine, 13125 Berlin, Germany",
    "Department of Human Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany",
    "Max Rubner Center for Cardiovascular Metabolic Renal Research, Charité- Universitätsmedizin Berlin, Corporate Member of the Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "G. Lishkova",
      "orcid": "0009-0008-1529-9582"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "O. Schweizerhof"
    },
    {
      "affs": [
        0
      ],
      "name": "J. Großmann"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "K. von Rohr"
    },
    {
      "affs": [
        1,
        3,
        5
      ],
      "name": "U. Landmesser"
    },
    {
      "affs": [
        1,
        5,
        6
      ],
      "name": "F. Edelmann"
    },
    {
      "affs": [
        7
      ],
      "name": "K. U. Eckardt"
    },
    {
      "affs": [
        1,
        8,
        9,
        10,
        11
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      "name": "M. Endres"
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        3,
        8,
        9
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      "name": "J. E. Weber"
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      "name": "U. Grittner"
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    {
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        13
      ],
      "name": "T. Pischon"
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    {
      "affs": [
        1,
        5,
        6
      ],
      "name": "J. Schulz-Menger"
    },
    {
      "affs": [
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        12,
        14
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      "name": "D. N. Müller"
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    {
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      "name": "J. Spranger"
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    {
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        15
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      "name": "L. Li"
    },
    {
      "affs": [
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        1,
        2,
        15,
        16
      ],
      "name": "K. Mai",
      "orcid": "0000-0003-0126-3155"
    }
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  "bibtex": "https://research.draconitic.com/paper/6mcthhcp4nyzb.bib",
  "cited_by": 0,
  "doi": "10.1186/s12933-026-03424-5",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711810/",
  "id": "6mcthhcp4nyzb",
  "issns": [
    "1475-2840"
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  "landing_url": "https://doi.org/10.1186/s12933-026-03424-5",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
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      "2705|Heart Failure Treatment and Management"
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  "pdf_url": "https://link.springer.com/content/pdf/10.1186/s12933-026-03424-5.pdf",
  "pmcid": "PMC13711810",
  "pmid": "42947108",
  "published": "2026-10-26",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/6mcthhcp4nyzb.ris",
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      "first_seen": "2026-10-31T12:22:31Z",
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      "subfield": "cardiovascular"
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  "title": "Meal-induced changes in cardiometabolic peptides in the context of acute cardiovascular diseases and glucose metabolism",
  "title_text": "Meal-induced changes in cardiometabolic peptides in the context of acute cardiovascular diseases and glucose metabolism",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:31Z",
  "url": "https://research.draconitic.com/paper/6mcthhcp4nyzb",
  "venue": "Cardiovascular Diabetology",
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