Multiple endothelial biomarkers and noninvasive vascular function in the general population: the Gutenberg Health Study.
Vascular reactivity is reflected by blood biomarkers and noninvasive vascular function measurement. The relation of biomarkers to flow-mediated dilation and peripheral arterial tonometry in the general population is little understood. In 5000 individuals (mean age, 56±11 years; age range, 35-74 years; 49% women) of the population-based Gutenberg Health Study we simultaneously assessed 6 biomarkers of cardiovascular function (midregional proadrenomedullin [MR-proADM], midregional pro atrial natriuretic peptide [MR-proANP], N-terminal pro B-type natriuretic peptide, copeptin, C-terminal proendothelin 1, and neopterin) in relation to flow-mediated dilation and peripheral arterial tonometry. Strongest partial correlations (adjusted for age and sex) were observed for baseline pulse amplitude with MR-proADM (r=0.13) and MR-proANP (r=-0.13); hyperemic response variables showed the highest correlation for MR-proADM and peripheral arterial tonometry ratio (r=-0.14). In multivariable linear regression models, strongest associations with baseline vascular function were observed for MR-proANP with baseline pulse amplitude (β per SD increase [99.17%], -0.080 [-0.115 to -0.044]; P<0.0001 after Bonferroni correction for multiple testing) and MR-proADM (-0.044 [-0.070 to -0.017]; P<0.0001), as well as MR-proANP (-0.033 [-0.057 to -0.009]; P=0.0017) and N-terminal pro B-type natriuretic peptide (-0.027 [-0.051 to -0.003]; P=0.015) with brachial artery diameter. For hyperemic response variables, highest associations were seen for peripheral arterial tonometry ratio with MR-proADM (-0.022 [-0.043 to -0.004]; P=0.043), MR-proANP (0.016 [-0.0034 to 0.035]; P=0.18), and C-terminal proendothelin 1 (-0.025 [-0.043 to -0.008]; P=0.00094]. In our large, population-based study, we identified MR-proADM and MR-proANP as circulating biomarkers of vascular function most strongly related to noninvasive measures of conduit artery and peripheral arterial performance. Whether determination of blood biomarkers helps to better understand vascular pathology and may provide prognostic information needs to be investigated in future studies.
University Heart Center, Department of General and Interventional Cardiology, Martinistr 52, 20246 Hamburg, Germany. schnabelr@gmx.de
Renate B
RB
Schnabel
Philipp S
PS
Wild
Andreas
A
Schulz
Tanja
T
Zeller
Christoph R
CR
Sinning
Sandra
S
Wilde
Jan
J
Kunde
Edith
E
Lubos
Karl J
KJ
Lackner
Ascan
A
Warnholtz
Tommaso
T
Gori
Stefan
S
Blankenberg
Thomas
T
Munzel
D053607:Adrenomedullin / Q000097:blood*; D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005858:Germany; D006020:Glycopeptides / Q000097:blood; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D019798:Neopterin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D012039:Regional Blood Flow / Q000502:physiology*
D015415:Biomarkers; C557077:C-terminal proendothelin-1; D019332:Endothelin-1; D006020:Glycopeptides; D010446:Peptide Fragments; D011498:Protein Precursors; C048197:copeptins; C552580:midregional pro-atrial natriuretic peptide, human; C109794:pro-brain natriuretic peptide (1-76); C088633:proadrenomedullin; D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin; D019798:Neopterin; D009320:Atrial Natriuretic Factor