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ABSTRACT

T he novel hypotensive peptide, adre n o-medullin (AM), was originally disc o v e red in human pheochro m o c y-toma (1). The major source of circ u l a t i n g AM is considered to be the vasculature (2), and this peptide may act as an antipro l i f e r-ative factor for vascular smooth muscle cells (3). Diabetes is characterized by long-t e rm complications, including re t i n o p a t h y, n e p h ro p a t h y, and neuro p a t h y, all of which a re closely related to vascular damage; the role of AM in diabetes has been investigated in this context. Insulin secretion in the pancreas is inhibited by AM, an intravenous injection of which reduces the plasma insulin concentration (4). Hyper-glycemia increases vascular AM expre s s i o n t h rough a protein kinase C (PKC)-dependent pathway (5). The issue of whether plasma levels of AM in diabetic patients with normal renal function are incre a s e d remains controversial (6–8). When evaluating the relationship between plasma levels of AM and glucose, patients with re n a l i m p a i rment should be excluded, because plasma AM levels in those patients with mild renal insufficiency and serum cre a t i-nine levels of 1.34 ± 0.10 mg/dl are thre e times higher than those in control individuals (9). We examined whether or not plasma AM levels are related to clinical parameters, including levels of plasma glucose and HbA 1 c , in diabetic patients without nephropathy through the use of a new immunoradiometric assay (10). A total of 77 diabetic patients (mean age 60.4 ± 1.3 years, 30 men and 47 women) and 15 healthy individuals (mean age 35.2 ± 3.7 years, 7 men and 8 women) p a rticipated in the study. Patients with s e rum creatinine levels 1.2 mg/dl, uri-n a ry protein that was positive according to the dipstick test, or urinary albumin that was 30 mg/day were excluded. Blood samples were taken from the antecubital vein into chilled polypropylene tubes containing EDTA 2Na (1 mg/ml of blood) and a p rotinin (500 U/ml of blood) early in the m o rning after an overnight fast. Plasma was obtained by immediate centrifugation at 4°C and 3,000 rpm for …

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