title: The influence of diabetes mellitus on midregional proadrenomedullin concentrations and prognostic value in heart failure outpatients.
abstract: BACKGROUND
  Diabetes mellitus (DM) is associated with an adverse outcome in heart failure (HF). Increased concentrations of midregional proadrenomedullin (MR-proADM) have been associated with DM and are predictors of mortality in HF patients. The aim of this study was to elucidate the impact of DM on MR-proADM concentrations and the prognostic value regarding all-cause mortality and hospitalization among HF patients.
  
  
  RESULTS
  We included 366 patients from an HF clinic; 69 (19%) had a history of DM and 40 (11%) had newly diagnosed DM (HbA1c ≥48 mmol/mol). The median MR-proADM concentration was unaffected by DM status (P = .20) but increased in HF patients with impaired renal function (P < .001). During a median follow-up of 55 months, 189 died, and 292 either died or were hospitalized. After adjustment for clinically relevant parameters, MR-proADM was associated with all-cause mortality (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1-1.4; P = .01) and the combined end point of death and hospitalization (HR 1.2, 95% CI 1.1-1.4; P = .02) per 1 SD increment of ln-transformed variable. No interaction between DM and MR-proADM was found regarding mortality or hospitalization.
  
  
  CONCLUSIONS
  Diabetes status had no impact on MR-proADM concentrations or in the predictive ability of MR-proADM in HF patients.
authors.affiliation: Endocrine Unit, Department of Medicine, Herlev University Hospital, Herlev, Denmark. Electronic address: pernille.holmager@regionh.dk.
authors.forename: Pernille
authors.initials: P
authors.lastname: Holmager
authors.affiliation: Department of Cardiology, Herlev University Hospital, Herlev, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Schou
authors.affiliation: Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Egstrup
authors.affiliation: Department of Cardiology, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: Ida
authors.initials: I
authors.lastname: Gustafsson
authors.affiliation: Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Goetze
authors.affiliation: Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
authors.affiliation: Department of Hematology, Herlev University Hospital, Herlev, Denmark.
authors.forename: Tobias Wirenfeldt
authors.initials: TW
authors.lastname: Klausen
authors.affiliation: Endocrine Unit, Department of Medicine, Herlev University Hospital, Herlev, Denmark; Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.affiliation: Endocrine Unit, Department of Medicine, Herlev University Hospital, Herlev, Denmark; Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kistorp
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C088633:proadrenomedullin; D053607:Adrenomedullin
keywords: Diabetes; adrenomedullin; heart failure; outcome