ABSTRACT
The present study was undertaken to determine plasma adrenomedullin [ADM] levels in patients with non-insulin dependent diabetes mellitus [NIDDM] to elucidate the potential involvement in the pathogenesis of diabetic complications. The patients were 31 males and 29 females with age ranging from 46-72 years [M +/- SD 57 +/- 12], the study were done at Al-Azhar University Hospitals and National Institute of Diabetes and Endocrinology between March 2000 and August 2000. Plasma ADM levels were 49.3 +/- 5.7 pg/ml in control subjects, 54.3 +/- 7.5 pg/ml in NIDDM patients without complications and 65.5 +/- 7.1 pg/ml in NIDDM with complications. Plasma ADM levels were significantly higher in NIDDM patients without complications than controls and in complicated vs non-complicated patients and their levels were not affected by plasma glucose concentrations. Plasma ADM levels increased dependently on the severity of diabetic complications and positively correlated with systolic blood pressure, serum creatinine, urinary excretion of albumin and fall in systolic blood pressure on standing up [sympathetic function]. In contrast, plasma ADM levels were reversely correlated with R-R interval on standing up 30:15 ratio [parasympathetic function] and conduction velocities of left ulnar nerves [peripheral neuropathy]. The results indicated that the increase in plasma ADM levels were closely related to diabetic complications, which may depend on the development of microangiopathy and play a certain role in protection against microvascular disturbance in diabetic patients