Vitamin B12 Supplementation and NT-proBNP Levels in COPD Patients: A Secondary Analysis of a Randomized and Controlled Study in Rehabilitation

• Published in: Frontiers in neuroscience Vol. 14; p. 740
• Main Authors: Paulin, Fernanda Viana, Goelzer, Leandro Steinhorst, Müller, Paulo de Tarso
• Format: Journal Article
• Language: English
• Published: Lausanne Frontiers Research Foundation 14-07-2020; Frontiers Media S.A
• Subjects: Chronic obstructive pulmonary disease; COPD; Dimensional analysis; exercise training; Hyperhomocysteinemia; Lung diseases; Maltodextrin; Methods; natriuretic peptides; Neuroscience; Normal distribution; Obstructive lung disease; Patients; Peptides; Physical training; Physiology; Rehabilitation; Secretion; Statistical analysis; Supplements; Ventricle; Vitamin B12
• ISSN: 1662-453X; 1662-4548; 1662-453X
• DOI: 10.3389/fnins.2020.00740

Purpose There is evidence of complex interaction between vitamin B12 (vB12) level, hyperhomocysteinemia, and natriuretic peptide secretion. Exercise training could also modulate such interaction. In this secondary analysis of a Randomized Clinical Trial performed in a chronic obstructive pulmonary disease rehabilitation setting, our primary objective was to investigate the interaction between vB12 supplementation, exercise training and changes in NT-proBNP levels after eight weeks of intervention. Secondary objectives were to explore the correlations between acute changes in NT-proBNP levels with (i) acute exercise and (ii) oxygen uptake (V´O2) kinetics during rest-to-exercise transition. Methods Thirty-two subjects with COPD were randomized into four groups: Rehabilitation+vB12(n=8), Rehabilitation(n=8), vB12(n=8) or Maltodextrin(n=8). They were evaluated at baseline and after eight weeks, during resting and immediately after maximal exercise constant work-rate tests (Tlim), for NT-proBNP plasmatic levels. Results After interaction analysis, the supplementation with vB12 significantly changed the time course of NT-proBNP responses during treatment (p=0.048). However, the final analysis could not support a significant change in NT-proBNP levels owing to high-intensity constant work-rate exercise (p-value >0.05). There was a statistically significant correlation between V´O2 time constant and ∆NT-proBNP values (Tlim – rest) at baseline (p=0.049) and two months later (p=0.015), considering all subjects (n=32). Conclusions We conclude that vB12 supplementation could modulate NT-proBNP secretion. Moreover, possibly, the slower the initial V´O2 adjustments toward a steady-state during rest-to-exercise transitions, the more severe the ventricular chamber volume/pressure stress recruitment, expressed through higher NT-proBNP secretion in subjects with larger V´O2 time constants, despite unchanged final acute exercise-induced neurohormone secretion.