The observation that human subcutaneous adipose tissue from obese subjects with T2D exhibits markedly increased natriuretic peptide (NP) receptor expression and higher clearance of NT-proBNP from the circulation [39] may explain why we observed a significant decrease in serum NT-proBNP without NPPB mRNA expression changes in the left heart of obese ZSF1 rats (Fig 3E and 3J). Here, NPPB is linked to type 2 diabetes mellitus.