MR-proADM as marker of endotheliitis predicts COVID-19 severity.

BACKGROUND: Early identification of patients at high risk of progression to severe COVID-19 constituted an unsolved challenge. Although growing evidence demonstrates a direct association between endotheliitis and severe COVID-19, the role of endothelial damage biomarkers has been scarcely studied. We investigated the relationship between circulating mid-regional proadrenomedullin (MR-proADM) levels, a biomarker of endothelial dysfunction, and prognosis of SARS-CoV-2-infected patients. METHODS: Prospective observational study enrolling adult patients with confirmed COVID-19. On admission to emergency department, a blood sample was drawn for laboratory test analysis. Primary and secondary endpoints were 28-day all-cause mortality and severe COVID-19 progression. Area under the curve (AUC) and multivariate regression analysis were employed to assess the association of the biomarker with the established endpoints. RESULTS: A total of 99 patients were enrolled. During hospitalization, 25 (25.3%) cases progressed to severe disease and the 28-day mortality rate was of 14.1%. MR-proADM showed the highest AUC to predict 28-day mortality (0.905; [CI] 95%: 0.829-0.955; P < .001) and progression to severe disease (0.829; [CI] 95%: 0.740-0.897; P < .001), respectively. MR-proADM plasma levels above optimal cut-off (1.01 nmol/L) showed the strongest independent association with 28-day mortality risk (hazard ratio [HR]: 10.470, 95% CI: 2.066-53.049; P < .005) and with progression to severe disease (HR: 6.803, 95% CI: 1.458-31.750; P = .015). CONCLUSION: Mid-regional proadrenomedullin was the biomarker with highest performance for prognosis of death and progression to severe disease in COVID-19 patients and represents a promising predictor for both outcomes, which might constitute a potential tool in the assessment of prognosis in early stages of this disease.

rs1501299 Polymorphism in the Adiponectin Gene and Their Association with Total Adiponectin Levels, Insulin Resistance and Metabolic Syndrome in Obese Subjects.

BACKGROUND AND AIMS: The aim of this study was to determine the association of single nucleotide polymorphism rs1501299 in the ADIPOQ gene with body weight, insulin resistance, serum adipokine levels and metabolic syndrome (MetS). METHODS: The study involved a population of 1,007 adult obese subjects. Parameters like body weight, fat mass, waist circumferences, blood pressure, fasting blood glucose, C-reactive protein, insulin concentration, homeostasis model assessment for insulin resistance (HOMA-IR), lipid profile and adipocytokines levels (leptin, adiponectin and resistin) were all measured. The genotype of ADIPOQ gene polymorphism (rs1501299) was evaluated. RESULTS: Insulin levels (GG: 13.6 ± 5.1 mUI/l vs. GT: 14.1 ± 5.2 mUI/l vs. TT: 16.6 ± 5.2 mUI/l; p < 0.05) and HOMA-IR (GG: 3.3 ± 1.5 units vs. GT: 4.1 ± 1.1 units vs. TT: 4.5 ± 1.3 units; p < 0.05) were higher in T-allele carriers than they were in non-T-allele carriers. Total adiponectin levels (GG: 20.2 ± 2.4 ng/dl vs. GT: 15.8 ± 3.4 ng/dl vs. TT: 13.7 ± 1.4 ng/dl; p < 0.05) were lower in T-allele carriers than they were in non-T-allele carriers. Logistic regression analysis indicated that subjects with T allele were associated with an increased risk of MetS (OR 1.15, 95% CI 1.08-1.25, p = 0.033) and an increased risk of hyperglycemia (OR 1.99, 95% CI 1.37-2.55, p = 0.028) after adjusting by age and gender. CONCLUSIONS: These data suggest an important role of this ADIPOQ variant at position +276 on insulin resistance, total adiponectin levels and MetS.

Descripción de factores de riesgo cardiovascular de una muestra de pacientes con isquemia crítica de miembros inferiores / Descriptive study of cardiovascular risk factors in a sample of patients with critical ischemia of lower limbs

Objetivo. Describir los factores de riesgo cardiovascular de la población intervenida por arterioesclerosis grave de miembros inferiores. Pacientes y métodos. Se ha realizado un estudio observacional durante un período de dos años, comprendido entre enero de 1999 y diciembre del 2000, con 330 pacientes intervenidos por enfermedad ateroesclerótica grave de miembros inferiores, con isquemia crítica. Resultados. La edad media fue de 74,78 ± 10,35 años; la edad de las mujeres fue mayor (78,88 ± 10,45 años) que la de los hombres (73,7 ± 10,07) (p < 0,0001), con una distribución por sexos de 261 hombres (79,1%) y 69 mujeres (20,9%). Si analizamos el porcentaje de pacientes obesos (índice de masa corporal ≥ 30), observamos una prevalencia del 12,2% de obesidad. El 37,4% de la población (n = 123) presentaba hipertensión arterial y sólo fue tratado el 63,4%. El 59,9% (n = 178) de la población del estudio mostraba dislipemia. Los niveles medios de glucosa plasmática fueron de 121,9 ± 55,8 mg/dL; el 42,4% (n = 140) de la población padecía diabetes mellitus y todos eran diabéticos de tipo 2. El 35,2% de los pacientes de nuestro estudio manifestaba dolor en reposo (estadio clínico III) y el 64,8% mostraba lesiones tróficas y/o gangrena, en correspondencia con el estadio IV de Fontaine. A los pacientes con isquemia crónica de miembros inferiores se les intervino quirúrgicamente –en un intento de revascularizar los tejidos isquémicos– una media de 2,2 ± 1,7 veces. Conclusión. Los pacientes con isquemia crítica de miembros inferiores presentan una alta prevalencia de factores de riesgo cardiovascular infratratados. El tipo de cirugía depende del estadio clínico

Aim. To describe the cardiovascular risk factors of a population secondary to severe atherosclerosis in limbs. Patients and methods. An observational study was performed during two years, from January 1999 to December 2000, with 330 patients with surgery secondary to critical ischemia of legs. Results. The mean age was 74.78 ± 10.35 years, with a higher age in females (78.88 ± 10.45 years) than males (73.70 ± 10.07) (p < 0,0001), with 261 males (79.1%) and 69 females (20.9%). Frequency of obese patients (body mass index ≥ 30) was 12.2%. A total of 37.4% had high blood pressure, and only 63.4% were treated. 59.9% (n = 178) of the population had dyslipemia. Average glucose levels were 121.9 ± 55.8 mg/dL, a total of 42.4% (n = 140) had diabetes mellitus, all people had diabetes mellitus type 2. A 35.2% of patients had pain on rest (III stage) and a 64,8% had trophic lessons (Fontaine stage IV). Patients with this disease received and average of 2.2 ± 1.7 surgeries. Conclusion. Patients with critical ischemia of limbs had a high prevalence of cardiovascular risk factors without pharmacological treatment. Type of surgery was related with the type of lesion