title: Plasma MR-proADM correlates to BMI and decreases in relation to leptin after gastric bypass surgery.
abstract: Adrenomedullin (ADM) is a vasoactive peptide found to be related to obesity and its comorbidities: type 2 diabetes, hypertension, atherosclerosis, and coronary heart disease. ADM is increased both in plasma and in adipose tissue of obese individuals when compared to lean subjects and is considered as a member of the adipokine family. We determined plasma midregional proadrenomedullin (MR-proADM) concentrations in a cohort of 357 subjects with BMI ranging from 17.5 to 42.3 kg/m2 and no additional medical history. In parallel, 28 severely obese patients scheduled to undergo laparoscopic Roux-en-Y gastric bypass (RYGB) surgery were studied at two time points: before and 1 year after surgery. Outcome measurements were: MR-proADM, cortisol, leptin, C-reactive protein (CRP) thyroid-stimulating hormone (TSH), creatinine and metabolic parameters. BMI correlated significantly to plasma MR-proADM levels (r=0.714, P<0.001), also after adjustment for age and gender (r=0.767, P<0.001). In obese subjects, there was a positive relationship between MR-proADM and leptin (r=0.511, P=0.006). Following RYGB, plasma MR-proADM decreased from 0.76+/-0.03 to 0.62+/-0.02 pg/ml (P<0.0001). RYGB-induced changes in MR-proADM correlated significantly to changes in leptin (r=0.533, P=0.004) and in CRP (r=0.429, P=0.023). We conclude that BMI is an independent predictor of circulating MR-proADM levels. Weight loss after RYGB is associated with a significant decrease in plasma MR-proADM, which is related to surgery-induced changes in both circulating leptin and systemic inflammation.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria. greisa.vila@meduniwien.ac.at
authors.forename: Greisa
authors.initials: G
authors.lastname: Vila
authors.forename: Michaela
authors.initials: M
authors.lastname: Riedl
authors.forename: Christina
authors.initials: C
authors.lastname: Maier
authors.forename: Joachim
authors.initials: J
authors.lastname: Struck
authors.forename: Nils G
authors.initials: NG
authors.lastname: Morgenthaler
authors.forename: Ammon
authors.initials: A
authors.lastname: Handisurya
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.forename: Bernhard
authors.initials: B
authors.lastname: Ludvik
authors.forename: Martin
authors.initials: M
authors.lastname: Clodi
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D015415:Biomarkers; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D020738:Leptin / Q000097:blood*; D008297:Male; D009765:Obesity / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D011498:Protein Precursors / Q000097:blood*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D020738:Leptin; D011498:Protein Precursors; C088633:proadrenomedullin; D053607:Adrenomedullin