Purpose: The aim of this study is to evaluate plasma biomarkers as predictors for peripheral arterial disease (PAD). Materials and methods: Prospective longitudinal cohort study of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer study (MDCS) (n = 5550; 1991-94). Cystatin C, copeptin, N-terminal pro-B-type natriuretic peptide (N-BNP), midregional proatrial natriuretic peptide (MR-proANP), mid-regional proadrenomedullin (MR-proADM), and conventional risk factors were measured at baseline. The diagnosis of symptomatic PAD was validated in 97% of the cases. Results: Cumulative incidence of PAD during median follow up of 23.4 years was 4.4% (men 5.9%, women 3.3%). Adjusted for age, sex, smoking, body mass index, hypertension, diabetes mellitus and total cholesterol, copeptin (hazard ratio [HR] 1.46; 95% confidence interval [CI] 1.19-1.80), N-BNP (HR 1.28; 95% CI 1.11-1.48), and cystatin C (HR 1.19; 95% CI 1.10-1.29) were independently associated with incident PAD. Subjects with the three biomarkers copeptin, N-BNP, and cystatin C in the highest quartiles, ran a high risk of incident PAD (HR 3.29; 95% CI 1.76-6.17) compared to those with no biomarker in the highest quartile. Conclusion: Copeptin, N-BNP, and cystatin C were associated with incident symptomatic PAD, implying that these biomarkers are sensitive indicators of early subclinical PAD. Clinical significance First prospective longitudinal cohort study evaluating Cystatin C, copeptin, N-terminal pro-B-type natriuretic peptide (N-BNP), midregional proatrial natriuretic peptide (MR-proANP), and mid-regional proadrenomedullin (MR-proADM) as predictors for peripheral arterial disease (PAD). Copeptin, N-BNP, and Cystatin C where independently associated with incident symptomatic PAD after adjustment for conventional risk factors. Copeptin, N-BNP, and Cystatin C seem to be sensitive indicators of early subclinical PAD.

中文翻译：

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Copeptin，B型利钠肽和胱抑素C与有症状的PAD相关。

目的：本研究的目的是评估血浆生物标志物作为外周动脉疾病（PAD）的预测指标。材料和方法：来自马尔默饮食与癌症研究（MDCS）的心血管研究队列的中年个体的前瞻性纵向队列研究（n = 5550； 1991-94）。在基线时测量了胱抑素C，肽素，N端pro-B型利钠肽（N-BNP），中部区域心钠素（MR-proANP），中部区域肾上腺髓质素（MR-proADM）和常规危险因素。有症状的PAD的诊断在97％的病例中得到了证实。结果：中位随访23.4年，PAD的累计发生率为4.4％（男性为5.9％，女性为3.3％）。调整了年龄，性别，吸烟，体重指数，高血压，糖尿病和总胆固醇，肽素（危险比[HR] 1.46；95％置信区间[CI] 1.19-1.80），N-BNP（HR 1.28； 95％CI 1.11-1.48）和胱抑素C（HR 1.19； 95％CI 1.10-1.29）与事件PAD独立相关。与在最高四分位数中没有生物标志物的受试者相比，在最高四分位数中具有三种生物标志物肽素，N-BNP和胱抑素C的受试者发生PAD的风险较高（HR 3.29； 95％CI 1.76-6.17）。结论：Copeptin，N-BNP和胱抑素C与症状性PAD相关，表明这些生物标志物是早期亚临床PAD的敏感指标。临床意义首次前瞻性纵向队列研究评估了胱抑素C，肽素，N端前B型利尿钠肽（N-BNP），中部区域心钠素（MR-proANP）和中部区域肾上腺髓质素（MR-proADM）外周动脉疾病（PAD）的预测因子。调整常规危险因素后，copeptin，N-BNP和Cystatin C独立与事件征状PAD相关。Copeptin，N-BNP和Cystatin C似乎是早期亚临床PAD的敏感指标。