This review provides background on the laboratory design for MESA (Multi-Ethnic Study of Atherosclerosis) as well as the approach used in MESA to select biomarkers for measurement. The research related to the multitude of circulating and urinary biomarkers of inflammation and other novel and emerging biological pathways in MESA is summarized by domain, or pathway, represented by the biomarker. The contributions of MESA biomarkers to our knowledge of these key pathways in the development and progression of atherosclerosis, cardiovascular disease, diabetes, kidney disease, and pulmonary disease are highlighted, as are the contributions of MESA to recommendations for clinical use of several of these biomarkers. In addition, contributions of MESA to multicohort genomics consortia and current collaborations in transomics and metabolomics are noted.

Highlights

• MESA (Multi-Ethnic Study of Atherosclerosis) has measured over 180 circulating and urinary biomarkers of inflammation and other novel and emerging specific biological pathways.
• Pathways include inflammation, insulin resistance, lipids and fatty acids, hemostasis and fibrinolysis, renal function, renin-angiotensin-aldosterone system, adipokines, atherosclerotic plaque stability, endothelial cell function, oxidative damage, vitamins and minerals, chronic infection, sex hormones, cardiac function, and immune cell profiles.
• These biomarkers have contributed to over 1,000 research articles and many clinical recommendations.
• Biomarker measurements are also being utilized in multicohort consortia examining genomics, transomics, and metabolomics.