Precursors of adrenomedullin, endothelin and atrial natriuretic peptide as diagnostic markers of neonatal infection

Aim: To evaluate the serum levels of three precursors of vasoactive peptide as diagnostic markers for neonatal infections. Methods: Overall, 356 neonates (160 without infection, 114 with mild infections and 82 with severe infections) were enrolled in this study. Their serum levels of mid-regional pro-adrenomedullin (MR-pro-ADM), C-terminal pro-endothelin-1 (CT-pro-ET-1) and mid-regional pro-atrial natriuretic peptide (MR-pro-ANP) were measured by immunoassay, and receiver operating curve analysis was performed for each biomarker to evaluate their diagnostic values for neonatal infection. Results: The serum levels of MR-pro-ADM (2.079 +/- 1.195 nM), CT-pro-ET-1 (109.4 +/- 62.9 pM) and MR-pro-ANP (1221.4 +/- 725.0 pM) in the severe infection group were significantly higher than those in the mild infection group (1.025 +/- 0.421 nM, 86.7 +/- 51.8 pM, and 687.6 +/- 575.7 pM, respectively) and in the non-infection group (0.853 +/- 0.488 nM, 51.3 +/- 40.6 pM, and 943.3 +/- 847.3 pM, respectively) (p < 0.01-0.001). Their areas under the curve were 0.72, 0.76 and 0.61, respectively. Among them, CT-pro-ET-1 had the highest sensitivity (82.65%), whereas MR-pro-ADM had the highest specificity (86.25%). Conclusions: MR-pro-ADM, CT-pro-ET-1 and MR-pro-ANP may serve as useful laboratory markers to indicate bacterial infection in neonates.