Rheumatology Advance Access originally published online on April 4, 2006
Rheumatology 2006 45(10):1266-1272; doi:10.1093/rheumatology/kel105
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Adrenomedullin—a potential disease activity marker and suppressor of nephritis activity in systemic lupus erythematosus
University Department of Medicine, Queen Mary Hosptial, The University of Hong Kong and 1Department of Medicine, Tuen Mun Hospital Hong Kong SAR, China.
Correspondence to: Prof. Chak Sing Lau, MD FRCP, University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China. E-mail: cslau{at}hkucc.hku.hk
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Abstract |
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Objectives. To investigate whether plasma adrenomedullin (AM) level is elevated in lupus nephritis and to examine if plasma AM level is correlated with systemic lupus erythematosus (SLE) disease activity and severity of lupus nephritis after multivariate adjustment.
Methods. Consecutive SLE patients and healthy volunteers of age 
16 were recruited from the rheumatology clinics of two hospitals in Hong Kong. SLE patients with nephritis fulfilled the American College of Rheumatology criteria for renal involvement and had percutaneous renal biopsy performed. Subjects were divided into three groups: (i) SLE patients with nephritis, (ii) SLE patients without nephritis and (iii) normal controls. The demographic and clinical variables were compared between these groups of patients and plasma AM level was determined by radioimmunoassay. Factors associated with plasma AM level were explored by regression analysis with adjustment of confounding factors.
Results. Sixty SLE patients (39 with nephritis and 21 without) and 23 normal subjects were studied. The plasma AM level of SLE patients was significantly higher than that of normal controls. SLE patients with nephritis had significantly higher plasma AM level than those without nephritis and normal controls (P<0.001). In regression analysis, proteinuria was negatively associated with plasma AM level (P=0.006) whereas SLE disease activity index was positively associated with plasma AM level after multivariate adjustment (P=0.002).
Conclusions. Plasma AM is elevated in lupus nephritis, which correlates with lupus disease activity. It is negatively associated with urine protein excretion although it is unrelated to the type of renal pathology per se. Plasma AM may play a role to suppress the activity of lupus nephritis.
KEY WORDS: Adrenomedullin, Lupus, Nephritis, Disease activity, Proteinuria
Submitted 22 November 2005;
revised version accepted 24 February 2006.
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