title: The significance of plasma adrenomedullin and calcitonin gene-related peptide concentration in patients with Type 2 diabetes mellitus who are treated for cardiovascular risk factors.
abstract: OBJECTIVE
  To evaluate the significance of plasma adrenomedullin and calcitonin gene-related peptide (CGRP) concentration in patients with Type 2 diabetes mellitus who are treated for hypertension and dyslipidemia.
  
  
  METHODS
  Plasma adrenomedullin and CGRP concentration, transthoracal echocardiography and ABPM were evaluated in 82 patients with Type 2 diabetes mellitus and 41 control subjects with no previous cardiovascular disease. All the subjects had casual blood pressure ≤140/90 mmHg or received antihypertensive medication, were treated by statin if LDL cholesterol was≥3mmol/L, by fibrates if triacylglyceroles≥2 mmol/L.
  
  
  RESULTS
  The mean age was 61±6 in patients with diabetes mellitus and 61±5 years in control subjects (p=0.9). Plasma CGRP was 3.0±1.8 in patients with diabetes mellitus and 2.3±1.0 ng/ml in control subjects (p=0.09). Plasma adrenomedullin was 2.2±0.9 in patients with diabetes mellitus and 2.8±1.1 ng/ml in control subjects (p=0.01). In patients with diabetes mellitus mass index of the left ventricle was significantly higher and the parameters of diastolic function were more deteriorated. Plasma adrenomedullin and CGRP correlated significantly negatively with serum creatinine and positively with mean 24 hours arterial blood pressure in patients with diabetes mellitus but not in control subjects. Plasma adrenomedullin concentration in patients with diabetes mellitus treated for hypertension was significantly reduced.
  
  
  CONCLUSIONS
  Despite concentration plasma adrenomedullin and CGRP modulation by cardioprotective treatment both neuropeptides remained involved in regulation of hemodynamic and metabolic parameters in patients with Type 2 diabetes mellitus. The low plasma of adrenomedullin in patients with Type 2 diabetic may be marker of the efficient intervention on cardiovascular risk factors.
authors.affiliation: Department of Medicine, 2nd Medical Faculty, Charles University and Faculty Hospital Motol, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Charvat
authors.affiliation: Department of Medicine, 2nd Medical Faculty, Charles University and Faculty Hospital Motol, Prague, Czech Republic.
authors.forename: Premysl
authors.initials: P
authors.lastname: Svab
authors.affiliation: Department of Medicine, 2nd Medical Faculty, Charles University and Faculty Hospital Motol, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Havlin
authors.affiliation: Institute of Endocrinology, Ministry of Health, Czech Republic.
authors.forename: Radovan
authors.initials: R
authors.lastname: Bilek
authors.affiliation: Institute of Endocrinology, Ministry of Health, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Zamrazil
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015740:Calcitonin Gene-Related Peptide / Q000097:blood*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D053607:Adrenomedullin; D015740:Calcitonin Gene-Related Peptide