The Role of Mid Regional Pro-adrenomedullin as a Biomarker for Early Cardio-Renal Dysfunction in Prediabetes and Type 2 Diabetes Mellitus _ A Prospective cohort study

Background: Cardiovascular and renal complications are leading causes of morbidity and mortality in patients with Prediabetes type 2 diabetes mellitus (T2DM). Identifying reliable biomarkers for early detection of cardio-renal dysfunction is essential to mitigate disease progression and improve clinical outcomes. This prospective cohort study evaluates the association between serum Mid-Regional Pro-adrenomedullin (MR-ProADM) levels and early signs of endothelial dysfunction in patients with prediabetes and T2DM. Method: The study was conducted at SRM Medical College Hospital and Research Centre, involving 90 participants divided equally into prediabetic and T2DM groups. Comprehensive clinical assessments included measurements of MR-ProADM, NT-ProBNP, eGFR, urine albumin-to-creatinine ratio (ACR), lipid profiles, and glycated hemoglobin (HbA1c). All these petameters are measured at baseline as well as after 1 year of follow-up. Finding: The study observed a significant increase in serum MR-ProADM levels in prediabetic and T2DM patients during follow-up compared to baseline. MR-ProADM correlated positively with early markers of endothelial dysfunction and cardio-renal impairment. Linear regression analysis confirmed strong associations with NT-ProBNP, Ejection fraction, eGFR, and ACR, indicating its potential as a predictive biomarker for cardiovascular and renal complications. ROC curve analysis further validated MR-ProADM’s diagnostic utility in identifying patients at risk. This study highlights MR-ProADM’s clinical relevance as a stable, reliable marker for early detection, risk assessment, and timely intervention in prediabetic and T2DM populations. Interpretation: Serum MR-ProADM shows potential as a reliable biomarker for early detection of cardio-renal dysfunction in prediabetes and T2DM. Its significant correlation with NT-ProBNP, Ejection fraction, eGFR, and ACR highlights its utility in predicting cardiovascular and renal complications, enabling timely intervention to improve clinical outcomes.