NPPA and metabolic syndrome: Circulating levels of NP are inversely related to BMI and they are lower in obese subjects and diabetic patients.[27–29] Atrial natriuretic peptide and BNP levels are decreased in individuals with metabolic syndrome and low plasma levels of NP are predictive of future development of diabetes.[28, 30, 31] Interestingly, the minor alleles of the genetic variants rs5068 and rs198389 that are associated with increased levels of ANP and BNP are also associated with lower risk of diabetes mellitus in whites.[9, 32]