Cross-sectional relations of multiple biomarkers from distinct biological pathways to brachial artery endothelial function.
BACKGROUND
Endothelial dysfunction is a critical intermediate phenotype in the pathogenesis of cardiovascular disease. We evaluated the relative contributions of distinct biological pathways to interindividual variation in endothelial function by relating prototype biomarkers (representing these pathways) to brachial artery vasodilator function.


RESULTS
We investigated the cross-sectional relations of a panel of 7 biomarkers measured at a routine examination to brachial artery vasodilator function (flow-mediated dilation [FMD] and reactive hyperemia) assessed at a subsequent examination (mean interval, 2.9 years) in 2113 Framingham Heart Study participants (mean age, 61 years; 54% women). We selected biomarkers from 4 biological domains: neurohormonal (N-terminal pro-atrial natriuretic peptide [N-ANP], B-type natriuretic peptide [BNP], renin, aldosterone), hemostatic factors (plasminogen activator inhibitor-1 [PAI-1]), inflammation (C-reactive protein [CRP]), and target organ damage (urine albumin-creatinine ratio). In age- and sex-adjusted models, several biomarkers were related to baseline brachial artery diameter (PAI-1, CRP, urine albumin-creatinine ratio), baseline mean flow (N-ANP, BNP, PAI-1, CRP, aldosterone), FMD (N-ANP, PAI-1, CRP, renin), and reactive hyperemia (BNP, PAI-1, CRP, renin, urine albumin-creatinine ratio). In multivariable analyses relating the 7 biomarkers conjointly to each vascular function measure (adjusting for known risk factors), N-ANP and renin were positively related to FMD (P=0.001 and P=0.04, respectively), and N-ANP was inversely related to baseline mean flow velocity (P=0.01). None of the other biomarkers was significantly related to the vascular function measures studied.


CONCLUSIONS
In our large community-based sample, a conservative strategy relating several biomarkers to vascular endothelial function identified plasma N-ANP as a key correlate of mean flow under basal conditions and of FMD in response to forearm cuff occlusion.
National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA 01702-5827, USA.
Sekar
S
Kathiresan
Philimon
P
Gona
Martin G
MG
Larson
Joseph A
JA
Vita
Gary F
GF
Mitchell
Geoffrey H
GH
Tofler
Daniel
D
Levy
Christopher
C
Newton-Cheh
Thomas J
TJ
Wang
Emelia J
EJ
Benjamin
Ramachandran S
RS
Vasan
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000502:physiology*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis; D007249:Inflammation / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D014664:Vasodilation
D015415:Biomarkers; D009320:Atrial Natriuretic Factor