Department of Medicine 2, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
Clin Chem Lab Med. 2013 May;51(5):1125-33. doi: 10.1515/cclm-2012-0541.
The use of biomarkers is firmly established for the assessment of cardiovascular disease. Emerging biomarkers such as midregional pro-atrial natriuretic peptide (MR-proANP) challenge established markers regarding risk prediction and stratification ability. The aim of the present study was to describe the distribution of a contemporary MR-proANP assay in a large population-representative sample and to evaluate the association with prevalent cardiac diseases and cardiovascular risk factors.
MR-proANP was determined by the use of a contemporary commercially available assay (BRAHMS GmbH, Hennigsdorf, Germany) in a representative sample of 5000 participants from the large population-based Gutenberg Health Study. N-terminal pro B-type natriuretic peptide (NT-proBNP) was used as a comparator.
Mean age was 55.5 ± 10.9 years. Coronary artery disease (CAD) was documented in 4.6%, heart failure (HF) in 1.5% of the study participants. We observed a moderate to strong correlation of the biomarkers with age, diabetes, hypertension, smoking, renal function, prevalence of CAD and HF. Males showed lower MR-proANP concentrations than females. MR-proANP showed no relevant correlation with BMI (ρ=-0.030) and CRP (ρ=0.039). Reference limits for MR-proANP representing the 95th/97.5th/99th percentile were determined for healthy individuals with 116/132/169 pmol/mL.
The current analysis in a large population-based sample elucidates the correlations and distribution of MR-proANP. Its concentration in healthy individuals depends on prevalent cardiovascular diseases and classical risk factors. The reported population-based reference values might be useful for distinguishing between healthy and diseased individuals, thus improving risk stratification and triaging in various clinical settings.
生物标志物的应用已被确定可用于评估心血管疾病。新兴生物标志物如 midregional pro-atrial natriuretic peptide (MR-proANP) 对风险预测和分层能力提出了挑战。本研究的目的是描述一种当代 MR-proANP 检测在大型代表性样本中的分布，并评估其与常见的心脏疾病和心血管危险因素的相关性。
使用一种当代商业上可用的测定法（BRAHMS GmbH，德国亨尼希多夫）在来自大型基于人群的 Gutenberg 健康研究的 5000 名参与者的代表性样本中测定 MR-proANP。将 N 末端 pro B 型利钠肽（NT-proBNP）作为比较。
平均年龄为 55.5±10.9 岁。研究参与者中有 4.6%患有冠心病（CAD），1.5%患有心力衰竭（HF）。我们观察到这些生物标志物与年龄、糖尿病、高血压、吸烟、肾功能、CAD 和 HF 的患病率呈中度至强相关性。男性的 MR-proANP 浓度低于女性。MR-proANP 与 BMI（ρ=-0.030）和 CRP（ρ=0.039）无显著相关性。代表健康个体第 95/97.5/99 百分位的 MR-proANP 的参考限值为 116/132/169 pmol/mL。
目前在大型基于人群的样本中的分析阐明了 MR-proANP 的相关性和分布。其在健康个体中的浓度取决于常见的心血管疾病和经典危险因素。报告的基于人群的参考值可能有助于区分健康和患病个体，从而改善各种临床环境中的风险分层和分诊。
