1. Adrenomedullin is a potent vasodilating peptide first isolated from phaeochromocytoma and adrenal medulla but also found in the heart, lungs and kidneys. It may also be a paracrine factor because endothelial and smooth muscle cells synthesize adrenomedullin as well as express the receptors. Adrenomedullin induces vasorelaxation by activating adenylate cyclase and also by stimulating the release of nitric oxide. 2. We have developed a specific radioimmunoassay and measured the immunoreactivity of human adrenomedullin in the plasma of 58 male subjects: eight with essential hypertension, 12 with heart failure, 10 with ascites due to cirrhosis, 12 with chronic renal failure, four with hypoxia due to chronic obstructive pulmonary disease and 12 control subjects. 3. Plasma levels (mean +/- SEM) in patients with essential hypertension (16.3 +/- 1.9 pmol/l), congestive heart failure (17.5 +/- 2.8 pmol/l) and renal failure (17.7 +/- 2.5 pmol/l) were raised compared with control subjects (7.8 +/- 1.4 pmol/l, P < 0.05), confirming previous reports. 4. In addition, we observed that plasma levels of adrenomedullin were significantly raised in patients with ascites due to liver cirrhosis (15.5 +/- 1.9 pmol/l) and chronic obstructive pulmonary disease with hypoxia (20.0 +/- 1.5 pmol/l). 5. We concluded that the plasma level of adrenomedullin is raised in a variety of diseases.

Objectives: To examine the validity of existing prediction equations for basal metabolic rate (BMR) and two generated regression equations in healthy Chinese subjects and patients with chronic diseases. Subjects: One-hundred and thirty-four healthy Chinese volunteers of aged 16 ± 88 among staff working in Shatin Hospital and their relatives, and 30 elderly patients with heart disease, stroke and chronic obstructive airway disease (COAD) were recruited. Interventions: Height, weight, biceps and triceps skinfold thickness, body fat percentage, and BMR were measured in the healthy subjects and patients. Two regression equations were derived from 70 healthy Chinese subjects. Three existing equations (WHO, Liu and Jia equations) and two derived equations were then crossvalidated in 64 subjects and 30 patients. Results: For the healthy Chinese subjects, as well as patients, the BMR calculated by Liu was the closest to the measured BMR among all the equations, although there was slight underestimation for patients. Conclusion: This study con®rms that the Liu equation is the most appropriate for predicting BMR in healthy Chinese subjects, but it underestimates the BMR in those with chronic diseases. Fat-free mass is the best predictor of measured BMR. Sponsorship: Unrestricted research grant in nutrition from the Bristol-Myers Squibb Foundation. Descriptors: basal metabolic rate; prediction equation; Chinese

Hypertension is an important risk factor for cardiovascular diseases. There is increasing evidence suggesting that inflammation is involved in the development of hypertension. Interleukin-6 (IL-6) is an important mediator of inflammatory response and the major regulator of hepatic production of acute phase proteins, such as fibrinogen and C-reactive protein (CRP), which have been associated with hypertension and cardiovascular diseases. Therefore, we studied the association of single nucleotide polymorphism (SNP) in the IL-6 gene (IL6) promoter with plasma levels of fibrinogen, CRP and hypertension. Five hundred and two Hong Kong Chinese subjects (282 normotensives and 220 hypertensives) were recruited. IL-6 gene promoter was examined for polymorphism and the study subjects were genotyped for any SNP identified. The IL6 À572C4G polymorphism (rs1800796) was found with a frequency of 0.23 for the minor G allele. Subjects with the À572G allele had significantly higher plasma fibrinogen (3.0670.57 vs 2.8370.60, P ¼ 0.002) and CRP (interquartile range 0.33-1.56 vs 0.12-0.93, P ¼ 0.003) levels than those without. The À572C4G polymorphism was found to be an independent predictor of fibrinogen and CRP levels after adjusting for confounding factors. Plasma concentrations of fibrinogen and CRP correlated with systolic blood pressure. However, the À572C/G genotype frequencies did not differ between hypertensive and normotensive subjects, and there was no association between À572C4G polymorphism and blood pressure. Our results provide evidence that there is a clear genetic influence of IL6 À572C4G polymorphism on plasma levels of fibrinogen and CRP, but this polymorphism does not lead to elevated blood pressure.