{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:13:52Z","timestamp":1789996432960,"version":"4.0.1"},"reference-count":32,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":2755,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,3,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The midregional fragment of proadrenomedullin (MR-proADM) is a marker of endothelial dysfunction and has been associated with a variety of diseases. Our aim was to investigate whether MR-proADM is associated with new-onset albuminuria and cardiovascular (CV) and all-cause mortality in patients with type 2 diabetes treated in primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESEARCH DESIGN AND METHODS<\/jats:title><jats:p>Patients with type 2 diabetes participating in the observational Zwolle Outpatient Diabetes Project Integrating Available Care (ZODIAC) study were included. Cox regression analyses were used to assess the relation of baseline MR-proADM with new-onset albuminuria and CV and all-cause mortality. Risk prediction capabilities of MR-proADM for new-onset albuminuria and CV and all-cause mortality were assessed with Harrell\u2019s C and the integrated discrimination improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In 1,243 patients (mean age 67 [\u00b112] years), the median follow-up was 5.6 years (interquartile range 3.1\u201310.1); 388 (31%) patients died, with 168 (12%) CV deaths. Log2 MR-proADM was associated with CV (hazard ratio 1.96 [95% CI 1.27\u20133.01]) and all-cause mortality (1.78 [1.34\u20132.36]) after adjusting for age, sex, BMI, smoking, systolic blood pressure, cholesterol-to-HDL ratio, duration of diabetes, HbA1c, ACE inhibitor\/angiotensin receptor blocker, history of CV diseases, log serum creatinine, and log albumin-to-creatinine ratio. MR-proADM slightly improved mortality risk prediction. The age- and sex-adjusted, but not multivariate-adjusted, MR-proADM levels were associated with new-onset albuminuria.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>MR-proADM was associated with CV and all-cause mortality in patients with type 2 diabetes after a median follow-up of 5.6 years. There was no independent relationship with new-onset albuminuria. In the availability of an extensive set of risk factors, there was little added effect of MR-proADM in risk prediction of CV and all-cause mortality.<\/jats:p><\/jats:sec>","DOI":"10.2337\/dc13-1852","type":"journal-article","created":{"date-parts":[[2013,10,30]],"date-time":"2013-10-30T02:53:21Z","timestamp":1383101601000},"page":"839-845","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":19,"title":["Midregional Fragment of Proadrenomedullin, New-Onset Albuminuria, and Cardiovascular and All-Cause Mortality in Patients With Type 2 Diabetes (ZODIAC-30)"],"prefix":"10.2337","volume":"37","author":[{"given":"Gijs W.D.","family":"Landman","sequence":"first","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iefke","family":"Drion","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kornelis J.J.","family":"van Hateren","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Struck","sequence":"additional","affiliation":[{"name":"AdrenoMed AG, Hennigsdorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaas H.","family":"Groenier","sequence":"additional","affiliation":[{"name":"Department of General Practice, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rijk O.B.","family":"Gans","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk J.G.","family":"Bilo","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, the Netherlands"},{"name":"Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands"},{"name":"Department of Internal Medicine, Isala Clinics, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan J.L.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanne","family":"Kleefstra","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Isala Clinics, Zwolle, the Netherlands"},{"name":"Department of Internal Medicine, University Medical Center Groningen, Groningen, the 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