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A17402 Mid-regional proadrenomedullin predicts reduced blood pressure and glucose elevation over time despite enhanced progression of obesity markers

Objectives: Elevated plasma levels of the vasodilating hormone adrenomedullin (ADM) predict cardiovascular disease and have been associated with hypertension and obesity. We aimed to examine the independent relationship between ADM and the progression of cardiometabolic risk factors during long-term follow-up. Methods: We studied mid-regional pro-adrenomedullin (MR-proADM) in fasting plasma in 3298 subjects from the population-based Malmö Diet and Cancer Study-Cardiovascular cohort, re-examined after 17 years, and related baseline MR-proADM to cardiometabolic risk factors cross sectionally and longitudinally. Results: At baseline, after full adjustment, each standard deviation (SD) increment of MR-proADM was independently related to (beta ± standard error, P-value) higher systolic blood pressure (SBP) (0.956 ± 0.319 mmHg, P = 0.003), body mass index (BMI) (0.912 ± 0.061 kg/m2, P = 1.42 x 10–48), waist (2.28 ± 0.158 cm, P = 8.46 x 10–46) and fasting blood glucose (FBG) (0.046 ± 0.018 mmol/L, P = 0.01). After full adjustment, including the baseline level of the risk factor whose degree of progression was studied, each SD increment of MR-proADM predicted significantly reduced progression of SBP ( − 1.170 ± 0.337 mmHg, P = 0.001) and FBG ( − 0.055 ± 0.023 mmol/L, P = 0.015), but greater increase of BMI (0.101 ± 0.051 kg/m2, P = 0.047) and waist (0.600 ± 0.144 cm, P = 3.1 x 10–5). Conclusion: Despite cross-sectional associations with higher levels of blood pressure and glucose, high levels of MR-proADM predict a slower progression of blood pressure and glycemia during long-term follow-up. Conversely, the cross sectional associations with higher levels of MR-proADM and obesity were paralleled by a faster progression of obesity markers over time. These results may be important for assessment of long term effects of therapies modulating levels of ADM.