Department of General and Interventional Cardiology, Hamburg University Heart Center, Martinistraße 52, 20246 Hamburg, Germany.
Atherosclerosis. 2013 Jun;228(2):451-9. doi: 10.1016/j.atherosclerosis.2013.03.006. Epub 2013 Mar 19.
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.
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.
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.
中区域原促肾上腺皮质素（MR-proADM）是一种对心血管系统具有多种作用的蛋白质。最近的研究强调了其在急性呼吸困难和心血管疾病患者中的预后意义。因此，我们旨在确定 MR-proADM 在普通人群中的分布，并揭示 MR-proADM 与心血管危险因素和亚临床心血管疾病测量值之间的潜在关联。
使用商业上可获得的荧光免疫测定法，在基于人群的哥廷根健康研究（N=5000）的个体中测定了 MR-proADM 血浆浓度。个体于 2007 年 4 月至 2008 年 10 月期间入组。使用超声心动图和心肌及血管功能的功能测量来评估亚临床心血管疾病。研究人群的平均年龄为 55.5±10.9 岁。在整个人群中，我们确定了男性和女性的 MR-proADM 血浆浓度中位数为 0.44 nmol/L。在患有高血压、糖尿病、血脂异常、已知心血管疾病、心力衰竭、外周动脉疾病、心房颤动以及心肌梗死和中风病史的个体中，MR-proADM 浓度升高。在男性中，我们观察到 MR-proADM 与射血分数降低、室间隔直径、壁厚度和舒张功能的超声心动图测量值之间存在正相关。
在这项研究中，我们在代表性人群样本中呈现了与年龄相关的 MR-proADM 参考值。升高的 MR-proADM 血浆浓度与经典心血管危险因素和明显的心血管疾病密切相关。此外，我们发现了与高血压的超声心动图测量值具有性别特异性的关联。MR-proADM 似乎是亚临床和明显心血管疾病的有前途的预后生物标志物。
