PLASMA ADRENOMEDULLIN LEVELS IN TYPE-1 DIABETES - RELATIONSHIP WITH CLINICAL-PARAMETERS

OBJECTIVE - To assess the relationship between plasma adrenomedullin ( AM) levels and the presence of microvascular complications in type 1 d iabetic patients. RESEARCH DESIGN AND METHODS - We measured plasma AM and cAMP levels in 103 type 1 diabetic patients (46 without complicati ons, 24 with retinopathy only, 14 with microalbuminuria but normal kid ney function, and 19 with renal insufficiency) and 41 matched healthy control subjects. RESULTS - Patients with renal insufficiency had high er levels of AM and cAMP than all other groups. Patients with only ret inopathy showed a trend to have higher levels than patients without co mplications. There were no differences among all other groups. There w as a significant correlation between AM and cAMP in the total diabetic group (r(s)= 0.36, P < 0.001) but not in the control group. In multip le regression analysis, plasma AM demonstrated significant relationshi ps with creatinine clearance (beta = -0.31, P = 0.004) and duration of the disease (beta = 0.28, P=0.008). CONCLUSIONS - Plasma AM and cAMP are increased in type 1 diabetic patients with renal insufficiency. Cr eatinine clearance (CrClc) and duration of the disease are related to plasma AM levels in these patients.