title: Association of MR-proadrenomedullin with cardiovascular risk factors and subclinical cardiovascular disease.
abstract: OBJECTIVE
  Midregional proadrenomedullin (MR-proADM) is a protein, which exerts various effects on the cardiovascular system. Recent studies underscored its prognostic implications in patients with acute dyspnea and cardiovascular diseases. Therefore, we aimed to determine the distribution of MR-proADM in the general population and to reveal potential associations of MR-proADM with cardiovascular risk factors and measures of subclinical cardiovascular disease.
  
  
  RESULTS
  MR-proADM plasma concentrations were determined in individuals of the population-based cohort of the Gutenberg Health Study (N = 5000) using a commercially available fluoroimmunoassay. Individuals were enrolled between April 2007 and October 2008. Subclinical cardiovascular disease was assessed using echocardiographic and functional measures of myocardial and vascular function. The mean age of the study population was 55.5 ± 10.9 years. In the overall population we determined a median MR-proADM plasma concentration of 0.44 nmol/L in men and women. MR-proADM concentrations were elevated in individuals with hypertension, diabetes, dyslipidemia, known cardiovascular disease, heart failure, peripheral artery disease, atrial fibrillation, and history of myocardial infarction and stroke. In men, we observed a positive association of MR-proADM with reduced ejection fraction, intraventricular septal diameter, wall thickness, and echocardiographic measures of diastolic dysfunction.
  
  
  CONCLUSIONS
  In this study, we present age-dependent reference values for MR-proADM in a representative population sample. Elevated MR-proADM plasma concentrations were strongly associated with classical cardiovascular risk factors and manifest cardiovascular diseases. Furthermore, we revealed a gender-specific association with echocardiographic measures of hypertension. MR-proADM seems to be a promising prognostic biomarker for subclinical and manifest cardiovascular disease.
authors.affiliation: Department of General and Interventional Cardiology, Hamburg University Heart Center, Martinistraße 52, 20246 Hamburg, Germany.
authors.forename: Johannes Tobias
authors.initials: JT
authors.lastname: Neumann
authors.forename: Stergios
authors.initials: S
authors.lastname: Tzikas
authors.forename: Anne
authors.initials: A
authors.lastname: Funke-Kaiser
authors.forename: Sandra
authors.initials: S
authors.lastname: Wilde
authors.forename: Sebastian
authors.initials: S
authors.lastname: Appelbaum
authors.forename: Till
authors.initials: T
authors.lastname: Keller
authors.forename: Francisco
authors.initials: F
authors.lastname: Ojeda-Echevarria
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.forename: Isabella
authors.initials: I
authors.lastname: Zwiener
authors.forename: Christoph R
authors.initials: CR
authors.lastname: Sinning
authors.forename: Annika
authors.initials: A
authors.lastname: Jagodzinski
authors.forename: Renate B
authors.initials: RB
authors.lastname: Schnabel
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Lackner
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.forename: Karsten
authors.initials: K
authors.lastname: Sydow
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D000328:Adult; D000367:Age Factors; D000368:Aged; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D015200:Fluoroimmunoassay; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D010641:Phenotype; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C574167:mid-regional pro-adrenomedullin, human; D053607:Adrenomedullin