EJMS

Abstract

Background: Adrenomedullin (AM) is a 52 amino acid vasoactive peptide, secreted mainly by endothelial cells in response to any vascular injury and counteracts against cardiovascular damage, essential hypertension, type 2 diabetes mellitus, and coronary artery diseases are three common diseases that affect human being and usually associated with atherosclerosis which can lead to fatal vascular complications. Early detection of vascular lesions is very important for protection against its complications. Aim of the work: To investigate the clinical utility of plasma adrenomedullin assay and its relationship with high sensitivity C-reactive protein (hs-CRP) in some diseases that commonly associated with atherosclerosis including coronary artery diseases, essential hypertension and type 2 diabetes mellitus. This may help early diagnosis of atherosclerosis. Patients and methods: seventy five subjects with age ranged from 33-58 years old with mean age value (45±9), sixty of them were patients and fifteen of them were healthy individuals (as a control group). The sixty patients were divided into three groups, coronary artery disease group, hypertensivegroup and diabetics group. Each group of them was 20 patients, all patricipants were subjected to complete medical history, clinical examination, laboratory investigations which included fasting blood glucose level, post prandial blood glucose level, serum creatinine, lipid profile (LDL, HDL, total cholesterol and triglycerides) and complete urine analysis. In addition serological test for plasma AM level and serum hs –CRP level by ELIZA were done. Results: plasma AM was significantly higher among patients compared with control P<0.01. Also there was significant increase in plasma AM in coronary artery group, hypertensive group more than diabetic groups compared to healthy subjects moreover plasma AM showed a significant positive correlations with hs–CRP, BMI, systolic and diastolic blood pressure, cholesterol and HDL (p<0.01). Conclusion: the results of the current study indicate that plasma adrenomedulline can represent a cardiovascular biomarker which reflects vascular function and remodling, also CRP represent an inflammatory biomarker that reflects vascular inflammation. So biomarkers in this study can provide early diagnostic and prognostic information about atherosclerosis. Using multiple biomarkers may be superior to using a single marker alone.